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Biochim Biophys Acta Gen Subj 12:129285

IR may be linked to endothelial dysfunction by the number of mechanisms such as disturbance in subcellular signaling pathway and PI-3-kinase/Akt pathway.[18] ACANTHOSIS NIGRICANS AND ADIPOKINES Acanthosis nigricans patients have hyperinsulinemia and may be at greater risk of atherosclerotic cardiovascular disease.[19] The commonest underlying cause of IR is excess abdominal adipose tissue which releases increased amounts of free fatty acids which directly affect insulin signaling, diminish glucose uptake in muscle, drive exaggerated triglyceride synthesis and induce gluconeogenesis in liver

doi: 10.1016/j.cell.2013.12.010 182 ZhuSZhangQSunXZehHJ3rdLotzeMTKangRet al

The cycle article in this cluster describes this dynamic in detail

Transmembrane helix 11 of multidrug resistance protein 1 (MRP1/ABCC1): identification of polar amino acids important for substrate specificity and binding of ATP at nucleotide binding domain 1