Additionally, the integrity of insulin signaling pathways might regulate LDL-C metabolism: insulin resistance accompanying hyperglycemia might impair the LDL receptor-mediated cholesterol clearance capacity in the liver, leading to a decoupling between elevated circulating LDL-C levels and renal LDL deposition (42, 43), thereby masking its association with DKD risk. The gene discussed is INS; the disease is Hyperglycemia.