Specifically, IH mediates immune imbalance through dual pathways: 1) IH upregulates IL-6, driving macrophages to infiltrate adipose tissue and polarize to the pro-inflammatory M1 phenotype, inducing adipose inflammation and exacerbating insulin resistance and atherosclerosis (91); 2) IH simultaneously enhances CCR5 expression on monocytes, increasing their endothelial adhesion and chemotaxis to accelerate the progression of atherosclerosis (92). The gene discussed is IL6; the disease is atherosclerosis.