Biomarkers of insulin sensitivity and insulin resistance: Past, present and future

Abstract

Insulin resistance in insulin target tissues including liver, skeletal muscle and adipose tissue is an early step in the progression towards type 2 diabetes. Accurate diagnostic parameters reflective of insulin resistance are essential. Longstanding tests for fasting blood glucose and HbA1c are useful and although the hyperinsulinemic euglycemic clamp remains a "gold standard" for accurately determining insulin resistance, it cannot be implemented on a routine basis. The study of adipokines, and more recently myokines and hepatokines, as potential biomarkers for insulin sensitivity is now an attractive and relatively straightforward approach. This review discusses potential biomarkers including adiponectin, RBP4, chemerin, A-FABP, FGF21, fetuin-A, myostatin, IL-6, and irisin, all of which may play significant roles in determining insulin sensitivity. We also review potential future directions of new biological markers for measuring insulin resistance, including metabolomics and gut microbiome. Collectively, these approaches will provide clinicians with the tools for more accurate, and perhaps personalized, diagnosis of insulin resistance.

Omentin-1 and risk of myocardial infarction and stroke: Results from the EPIC-Potsdam cohort study

“…Interestingly, adiponectin and omentin-1 share the same pattern of physiological effects i.e. both are downregulated in obesity [3,28], both have been proposed to have a beneficial effect on glucose metabolism and insulin sensitivity [1,29], and both were discussed as cardio-protective adipokines [28,30]. However, the association between omentin-1 and stroke risk was particularly strong among individuals with high adiponectin levels compared to those with low levels.…”

Relationship of Serum Fetuin A with Metabolic and Clinical Parameters in German Children and Adolescents with Type 1 Diabetes

“…The question has been raised as to whether fetuin A could be a biomarker for insulin sensitivity [24], while its role in the pathogenesis of insulin resistance is not yet completely elucidated [22, 23]. Possible mechanisms of action are multimodal: fetuin A inhibits insulin signaling by interference with insulin receptor tyrosine kinase phosphorylation [25-28] and the translocation of the glucose transporter GLUT4 in insulin target tissues [5].…”

Can Avicenna Help Manage the Diabetes Epidemic in Central Asia?

“…It has been shown that p53 has the capacity to control the expression of metabolism-related genes that are important regulators of metabolic pathways, including glycolysis, oxidative phosphorylation, fatty acid metabolism and mTOR signaling [23]. Intensive research in biomarkers for IR has suggested several target candidates, including adiponectin, retinol-binding protein-4 (RBP4), chemerin, adipocyte fatty acidbinding protein, fibroblast growth factor (FGF21), fetuin-A, myostatin, interleukin (IL-6), irisin, and ghrelin, all of which may play a significant role in determining insulin sensitivity [24][25][26]. The elevation in baseline serum uric acid was found to be an independent risk factor for gout, hypertension and both IR and T2DM [27].…”