INSR and Insulin resistance: Elevated CRP levels can exacerbate insulin resistance by activating the NF-κB pathway, affecting the expression of pro-inflammatory factors (e.g., IL-6, TNF-α), and inhibiting the phosphorylation of insulin receptor substrate.[33–35] Chronic inflammation also accelerates endothelial cell apoptosis and atherosclerotic plaque formation, which is an important mechanism for increased cardiovascular mortality in diabetic patients.[36,37] More importantly, there is a significant interaction between these 3 factors.