CCL2 and polycystic ovary syndrome: IR activated NF-κB, promoted the expression of IL-6 and MCP-1, and transformed macrophages to the M1.[50] Visfatin is an adipokine, it exerts an insulin-like effect by binding to the insulin receptor-1 and has a hypoglycemic effect.[51] There was no significant increase in plasma visfatin levels or visfatin gene expression in monocytes and monocyte-derived macrophages in peripheral blood of PCOS patients in Zhang experiment.[52] Considering their findings, studies of the effects of macrophages on PCOS or IR should examine macrophages in tissues rather than peripheral blood.