Potentially novel surrogate biomarker for diagnosing insulin resistance in type 2 diabetes

Abstract

Type 2 diabetes mellitus (T2DM) and obesity are growing global pandemics that shares the common characteristic of insulin resistance (IR). IR leads to progressive β-cell failure, worsening T2DM and its cardiovascular complications. Thus, early diagnosis of IR is important to prevent and reverse β-cell dedifferentiation. However, there is a lack of accessible, non-invasive and affordable tools to early diagnose and stratify IR. The gold standard method used in the research setting is the hyperinsulinemic-euglycemic clamp, however it is invasive, laborious, expensive and difficult to apply at a large scale. Hou et al presents a potential novel surrogate biomarker for diagnosing IR in T2DM. Magnetic resonance imaging derived biomarkers can potentially become the accessible and non-invasive alternative to the hyperinsulinemic-euglycemic clamp, enabling the timely diagnosis of IR with potential clinical applications in T2DM treatments and preventative care.

Keywords: Insulin resistance; Type 2 diabetes mellitus; Metabolic syndrome; Beta-cell dedifferentiation; Ectopic lipid; Magnetic resonance imaging derived biomarkers; Multiparametric imaging; Intramyocellular lipid; Obesity; Personalised precision medicine

Core Tip: Hou et al presents a potential novel surrogate biomarker for diagnosing insulin resistance (IR) in type 2 diabetes mellitus. Their study demonstrates magnetic resonance imaging-derived multiparametric biomarkers for IR at the L4-L5 paravertebral muscles. If validated, this represents an accessible and non-invasive tool for early diagnosis of IR with potential clinical diagnostic applications.