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Insulin Insulin, a major negative regulator of adipocyte lipolysis, binds the insulin receptor (IR) and through the docking protein insulin receptor substrate 1 (IRS1) and IRS2 (116), activates the lipid kinase phosphatidylinositol 3-kinase (PI3-K), increasing production of PIP3 which stimulates the serine threonine kinase AKT/Protein kinase B (117) (Figure 2)

Zhang, M.L., and Johnson, R.T

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Patients with even mid-range to high-range levels of vitamin B12 often still have a high MCV and high homocysteine (discussed below) and can benefit from vitamin B12 levels