In addition, key transcriptional regulators that control VSMC proliferation, cell cycle progression, cell survival, and transformation into de-differentiated, inflammatory, and osteoblastic phenotypes in response to obesity, hyperglycemia, and insulin resistance, include KLF4, KLF5, FOXO1, STAT1/3, SRF, MYOCD, NFκB, and Msx2. Here, MSX2 is linked to Insulin resistance.