TL;DR
Lower serum lithium levels independently predict insulin resistance in T2DM, alongside ICPR and TyG index, and a potential mechanistic role for lithium in metabolic dysregulation is suggested.
Vitamin D deficiency is an increasingly recognized yet poorly addressed metabolic risk factor that may aggravate insulin resistance in patients with type 2 diabetes mellitus (T2DM), thereby worsening glycemic control and long-term outcomes. Therefore, it is of interest to examine the association between serum 25-hydroxyvitamin D [25(OH)D] levels and markers of insulin resistance including the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), fasting insulin, fasting blood glucose and HbA1c in 120 patients with confirmed T2DM. Serum vitamin D levels were significantly lower in patients with higher HOMA-IR values, with a strong inverse correlation observed between serum vitamin D and HOMA-IR (r = −0.72, p<0.001). The prevalence of insulin resistance (HOMA-IR >2.5) was 92.9% in severely deficient patients compared to 20.0% in those with sufficient vitamin D levels. Thus, data shows the clinical importance of routine vitamin D assessment in T2DM patients as a potentially modifiable target to reduce insulin resistance and improve glycemic outcomes.
C-peptide can be used as an appropriate index for identifying IR in T2DM patients with complications and illustrated the clinical utility of C-peptide in microvascular complications such as diabetic nephropathy and diabetic retinopathy.
Background and objective: Diabetes Mellitus type 2 (T2DM) represents a serious risk to public health known as hyperglycemia. High levels of serum leucine a branched chain amino acid have been associated with early insulin resistance and metabolic imbalances. This study investigates the relationship between serum leucine levels and insulin resistance, and to evaluate its potential as a biomarker alongside standard blood sugar markers in diabetic, prediabetic, and leucine-supplemented individuals undergoing training. Methods: A cross-sectional study, conducted at the (Galiawa hospital for diabetes and endocrinology and (AKA Fitness) center)/ Erbil city / Iraq. A total of 155 participants, aged between 30 and 69, were included, composed of 46 with T2DM, 38pre-diabetic patients, 36 non-diabetic and 35 healthy young active training individuals who received leucine supplementation. Data was collected by interview questionnaire about; sociodemographic, life style and results of biochemical tests. Results: High levels of serum Leucine were significantly increase with age, obesity (OR=2.4, 95% CI. 1.7 - 2.8) and increased risk of high fasting blood sugar (OR=1.14,95% of CI 1.09-1.18), HbA1c (OR=1.24, 95% of CI 1.12-1.37), and insulin resistance (OR= 1.06, 95% of CI 1.02-1.1) in diabetic and prediabetic. Excessive supplementation caused excess serum leucine levels and increase potential insulin resistance (OR=1.3, 95% CI I,07-1.6) with advancing age. Conclusion: High serum leucine levels can cause insulin resistance in elderly, obese, prediabetic, and diabetic patients, suggesting its potential use as a biomarker for early diagnosis. A low dose of leucine supplementation should be considered in individuals undergoing training.
Background: Type 2 diabetes mellitus (T2DM) is one of the most common chronic metabolic diseases worldwide, and insulin resistance is the core pathophysiological basis for its development. This study aims to explore the relationship between various metabolic-related indicators and insulin resistance in patients with T2DM, and to analyze the correlation between obesity indicators, glucose and lipid metabolism indicators, and serum uric acid with insulin resistance, providing a reference for clinical identification of insulin resistance.Methods: This was a single-center retrospective study, consecutively enrolling 263 patients with type 2 diabetes who received treatment at our center between August 2022 and August 2025. Patients were divided into a non-insulin-resistant group (n = 211) and an insulin-resistant group (n = 52) based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Baseline clinical data and laboratory parameters were collected, including body mass index, waist-to-hip ratio, fasting blood glucose, 2-hour postprandial blood glucose, lipid profile, glycated hemoglobin, fasting C-peptide, and serum uric acid. The triglyceride-glucose (TyG) index was also calculated. Logistic regression analysis was performed to screen for metabolic indicators associated with insulin resistance, and receiver operating characteristic (ROC) curve analysis was then conducted to evaluate the discriminative ability of these indicators for insulin resistance.Results: Patients in the insulin resistance group had significantly higher levels of body mass index (BMI), waist-to-hip ratio (WHR), triglycerides, fasting blood glucose, TyG index, fasting C-peptide, glycated hemoglobin (HbA1c), systolic blood pressure, diastolic blood pressure, and serum uric acid than the non-insulin resistance group (all p < 0.05), and a higher proportion of patients with hypertension (65.38% vs. 46.45%, p = 0.014). Multivariate logistic regression analysis showed that WHR, TyG index, fasting C-peptide, and serum uric acid were independently associated with insulin resistance. The area under the curve (AUC) for assessing insulin resistance using the combined indicators was 0.81 (95% CI: 0.74–0.88), with a sensitivity of 79.0% and a specificity of 71.0%.Conclusion: In patients with type 2 diabetes, WHR and serum uric acid levels are significantly correlated with insulin resistance status. These indicators reflect various metabolic characteristics from different perspectives, including obesity, glucose and lipid metabolism, and pancreatic β-cell function, and may provide preliminary insights into the metabolic abnormalities associated with insulin resistance in patients with type 2 diabetes.
In patients with T2DM, UCPCR could be used as a simple, noninvasive and available biomarker for IR and it also could be used as a marker of glycemic control.
AIM Obesity is a major contributor to insulin resistance (IR) and cardiometabolic diseases, but IR can manifest in a tissue-specific manner, resulting in discordant IR phenotypes. This study characterized metabolic and clinical differences between individuals with adipose and muscle IR. METHOD Baseline data from 229 adults (40-75 years, BMI 25-40 kg/m2) in the PERSON study were analyzed. Participants were categorized into four groups based on indices of muscle and adipose insulin sensitivity. Muscle IR was assessed with a 7-point oral glucose tolerance test, and adipose IR was determined from fasting plasma insulin and non-esterified fatty acids. Detailed phenotyping was performed under controlled conditions and daily life. RESULTS 42% of participants displayed discordant IR patterns. Independent of muscle IR, adipose IR was associated with an adverse cardiometabolic profile, including abdominal fat accumulation, higher fasting insulin, HOMA-IR and triglycerides, greater glycemic variability, and more liver fat and hepatic IR. In contrast, individuals with isolated muscle IR maintained a relatively healthy cardiometabolic profile, though women exhibited higher muscle fat infiltration and hepatic IR. CONCLUSION These findings demonstrate that adipose IR is more strongly and consistently linked to impaired metabolic health than muscle IR, highlighting the importance of phenotype-specific strategies for prevention and treatment.