Serum FTO Protein Levels in Newly Diagnosed Type 2 Diabetes Patients in Syria: A Case‒Control Study

Serum FTO Protein Levels in Newly Diagnosed Type 2 Diabetes Patients in Syria: A Case‒Control Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Serum FTO Protein Levels in Newly Diagnosed Type 2 Diabetes Patients in Syria: A Case‒Control Study Hadil Faried Shamsaldeenalsagher, Sheden Izzat Haddad This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8321576/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 26 You are reading this latest preprint version Abstract Introduction: Type 2 diabetes is often accompanied by obesity, particularly visceral obesity. On the other hand, The FTO protein is associated with body mass index (BMI). It acts as an enzyme that induces epigenetic modifications in multiple genes. suggesting that the FTO protein is associated with several metabolic disorders, such as type 2 diabetes. Our study aimed to evaluate the protein levels of FTO in Syrian patients newly diagnosed with type 2 diabetes. Methods: This case‒control study involved 80 participants selected from the National University Hospital in Damascus.it divided into two primary groups: 44 newly diagnosed type 2 diabetic patients and 36 nondiabetic participants, including 22 obese participants and 14 normal weight participants. Serum levels of FTO protein were measured by Sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA), fasting blood glucose (FBG), glycated hemoglobin (HbA1c), fasting insulin (FINS) and insulin resistance were assessed for each participant. The statistical analysis was performed using IBM SPSS statistics (version 27) software. The Mann‒Whitney test, the independent t test, ANOVA and the Kruskal‒Wallis test were used. Correlations were assessed via Pearson’s test and via Spearman’s test for the subgroups. A p value 0.05), but they differ between the obese-nondiabetic group and the normal weight- nondiabetic group(p 0.05). Discussion: Serum levels of FTO appear to be more strongly associated with obesity than with diabetes. Type 2 diabetes obesity FTO protein insulin insulin resistance Syrians 1. Introduction Type 2 Diabetes (T2D) is a multifactorial metabolic disorder. T2D accounts for 90–95% of diabetes cases, and it is one of the most significant noncommunicable chronic diseases that seriously threatens human health. This type of diabetes is characterized by two main insulin-related abnormalities: insulin resistance and β-cell dysfunction [ 1 ]. According to International Diabetes Federation (IDF) statistics for 2024, 19% of Syrians suffer from type 2 diabetes, and the number is expected to increase if the risk factors for the disease are not controlled [ 2 ]. Type 2 diabetes is often associated with obesity, especially visceral obesity, which leads to chronic inflammation in the body[ 3 ], contributing to the development of heart diseases, hypertension and cancer in addition to diabetes [ 4 ]. The fto gene is located on chromosome 16q12.2 and was named the "FATSO gene" because of its large size (approximately 410.50 kb) [ 5 ]. The fto gene was originally thought to be associated with programmed cell death, several neurological diseases, growth failure, early death in children, and the phenomenon of fused fingers in embryos [ 6 ]. However, in 2007, Genome-Wide Association Studies (GWAS) identified it as the first gene related to body mass index (BMI), so it was renamed fat mass and obesity-associated protein (FTO)[ 7 ]. The fto gene contains 8 introns and 9 exons and encodes the 2-oxoglutarate Fe + 2-dependent AlkB family dioxygenase. Although this enzyme is involved in DNA repair and demethylation, this process is reversible [ 8 ]. Methyl-6-adenosine (m 6 A) is considered the main substrate for the FTO protein. The FTO protein is expressed in various tissues with high expression levels in the hypothalamus. FTO plays a role in posttranscriptional regulatory processes such as RNA splicing, nuclear production, degradation, and translation [ 9 ]. Different studies have shown the relationship between gluconeogenesis and lipogenesis [ 10 ], indicating its role in regulating appetite and metabolic processes [ 11 ] [ 12 ]. The number of studies on serum FTO protein levels is limited, especially in diabetic patients, and there are no studies on FTO protein within the Syrian population. Therefore, our study aimed to assess the serum levels of FTO protein in newly diagnosed Syrian patients with type 2 diabetes. Our study is the first to assess the serum levels of FTO protein in newly diagnosed type 2 diabetic patients. 2. Materials and Methods 2.1. Study design: This case‒control study was conducted with 80 participants divided into two primary groups: 44 newly diagnosed diabetes patients and 36 nondiabetic individuals from the Endocrinology Department at the National University Hospital in Damascus, Syria. The primary study groups were further divided into subgroups "(four groups)". The case group was divided into two subgroups: obese diabetic patients and nonobese diabetic patients, the control group was divided into two subgroups: nondiabetic obese individuals and nondiabetic normal weight individuals. 2.2. Ethical considerations: This study was approved by the Biomedical Research Ethics Committee at Damascus University under the number PH-210224-210 on February 2024[ 13 ]. A blood sample was drawn after the participants signed the consent form (one form per participant). The samples were collected between February 2024 and March 2025 at the National University Hospital in Damascus. 2.3. The inclusion criteria for the study groups were as follows : -Inclusion criteria for the case group: the obese diabetic patients were newly diagnosed with T2D according to the American Diabetes Association (ADA) criteria [ 14 ], with obesity defined by the World Health Organization (WHO) (BMI ≥ 30 kg/m²) [ 15 ]. The participants were between 38 and 65 years of age. Nonobese Diabetes patients newly diagnosed with T2D according to the ADA criteria [ 14 ], with a BMI ≤ 30 kg/m² on the basis of the WHO criteria [ 15 ]. The participants were aged between 38 and 65 years. -Inclusion criteria for the control group: nondiabetic obese individuals: No diabetes diagnosis, obesity defined by the WHO criteria (BMI ≥ 30 kg/m²) [ 15 ], aged between 38 and 65 years. Nondiabetic normal weight individuals: No diabetes diagnosis, normal weight based on WHO criteria (BMI between 18.5 and 24.9 kg/m²) [ 15 ], aged between 38 and 65 years. 2.4. The Exclusion criteria for the study groups: Individuals treated with insulin or antihyperglycemic agents, lipid-lowering agents, loop or thiazide diuretics, those with cardiovascular diseases, thyroid diseases, liver or kidney disorders, autoimmune diseases, infectious diseases and cancers. Women with polycystic ovary syndrome, pregnant women and breastfeeding mothers. 2.5. Anthropometric measurements and indices Body: The participants were examined by endocrinologists, and the required research data were gathered, including a review of each participant's medical history and anthropometric measurements. Weight and height were measured via a standardized scale, with participants wearing light clothing and no shoes. Waist, hip, and neck circumferences were measured via a no stretchable measuring tape. Waist circumference (WC) was measured between the lower rib and the hip bone, passing over the navel, with the tape measure held flat against the skin without applying pressure. Hip circumference (HC) was measured at the widest point of the buttocks, also without applying pressure, with the torso upright and feet together. Neck circumference (NC) was measured with the head in a neutral position, with the tape passing across the thyroid cartilage without applying pressure. 2.6. Sample collection, preparation and analysis: After a 12-hour overnight fast, 6 mL of venous blood was collected from each participant via sterile venipuncture and distributed into two tubes. A 2 mL blood sample was collected in an EDTA tube, which was used for the estimation of glycated hemoglobin as a percentage of total hemoglobin, using a kit for turbidimetric inhibition immunoassay (TINIA) provided by Roche Diagnostics, Switzerland [ 16 ]. The remaining 4 mL of blood was placed in a clot activator tube. After blood clotting, the sample was centrifuged at 3000 × g for 15 minutes, and a portion of the serum was collected for immediate determination of fasting blood glucose via an enzymatic colorimetric test via a Roche kit, Switzerland [ 17 ]. The remaining serum was stored at − 80°C until further analysis of fasting serum insulin and serum FTO protein levels. Serum insulin levels were measured via an electrochemiluminescence immunoassay (ECLIA) via a kit provided by Roche Diagnostics, Switzerland [ 18 ]. Serum FTO protein levels were measured via an ELISA kit provided by My BioSource, USA [ 19 ]. The laboratory work was conducted at the National University Hospital Laboratory in Damascus. 2.7. Calculations: Body mass index (BMI) was calculated by dividing weight (kg) by the square of height (m²). The waist/hip ratio (WHR) and waist/height ratio (WHtR) were subsequently calculated. Insulin resistance was determined via the HOMA-IR formula = fasting glucose (mg/dl) x fasting insulin (µU/mL)/405. 2.8. Statistical analysis: The data were manually collected in an Excel spreadsheet. Statistical analyses and study correlations were performed via IBM SPSS Statistics version 27. Numerical data are expressed as the mean ± standard deviation for normally distributed samples and as the median ± interquartile range for nonnormally distributed samples. Numerical variables were compared between primary groups via the Mann‒Whitney test and the independent t test. For comparisons between subgroups, ANOVA and the Kruskal‒Wallis test were used, depending on the sample distribution pattern. The chi-square test was used for categorical variables. Correlations were assessed via Pearson’s test for the primary groups and via Spearman’s test for the subgroups. A p value < 0.05 was considered statistically significant. 3. Results 3.1 Demographic and anthropometric parameters : This study was a case‒control study that included 44 newly diagnosed individuals with T2D and 36 control participants without diabetes (22 obese and 14 normal weight individuals). There were no significant differences between the groups in terms of age or sex (p > 0.05). Differences between groups: Significant differences were observed between the subgroups (normal weight without diabetes, obese without diabetes, nonobese diabetes and obese diabetes) in terms of weight, BMI, WC, HP, NC, Waist/hip ratio (WHR), and Waist/height ratio (WHtR) (p 0.05). See Table 1 Table 1 Demographic and anthropometric parameters of the studied group. Variable Normal weight without diabetic (n = 14) Obese without diabetic (n = 22) Non obese diabetes (n = 22) Obese diabetes (n = 22) P P1 P2 P3 P4 P5 P6 Age 47.38 ± 6.9 47.45 ± 6.4 52.5 ± 6.5 49.1 ± 6.9 0.057 * 1 0.085 0.539 1 1.88 1 sex - - - - 0.173 *** male 7(50%) 10(45.45%) 17(77.27%) 12(54.54%) - female 7(50%) 12(54.54%) 5(22.72%) 10(45.45%) - Weight(kg) 58 ± 6.1 100 ± 15.9 77.35 ± 11 102.1 ± 16.3 0.001 * 0.001 0.001 0.001 1 0.001 0.001 Height(m) 164.3 ± 9.3 166.36 ± 11.9 169.18 ± 10.6 166.68 ± 9.9 0.637 * 1 1 1 1 1 1 BMI) kg/m 2 ) 21.38 ± 1.67 34.7 ± 4.4 26.9 ± 2.25 34.8 ± 7.6 0.001 ** 0.001 0.001 0.001 0.778 0.043 0.001 WC 79.3 ± 4.9 112.14 ± 1.94 100.9 ± 6.4 116.77 ± 10.8 0.001 * 0.001 0.001 0.001 0.432 0.001 0.001 HC 93.46 ± 4.8 120.64 ± 6.9 104.55 ± 5.4 118.1 ± 11.7 0.001 * 0.001 0.001 0.001 1 0.001 0.001 WHR 0.85 ± 0.05 0.93 ± 0.09 0.96 ± 0.05 0.99 ± 0.09 0.001 * 0.15 0.895 1 0.058 0.001 0.001 WHtR 0.48 ± 0.04 0.67 ± 0.05 0.59 ± 0.04 0.7 ± 0.06 0.001 * 0.001 0.001 0.001 0.603 0.001 0.001 NC 34.15 ± 1.86 40.1 ± 4.6 39.71 ± 3.5 42.8 ± 3.9 0.001 * 0.001 1 0.051 0.110 0.001 0.001 BMI: Body Mass Index, WC: Waist Circumference, HC: Hip Circumference, WHR: Waist/Hip Ratio, WHtR: Waist/Height Ratio, NC: Neck Circumference P1 between normal weight and obese groups. P2 between obese without diabetic and nonobese diabetes groups P3 between non obese diabetes and obese diabetes groups P4 between obese and obese diabetes groups P5 between non obese diabetes and normal weight groups. P6 between obese diabetes and normal weight groups. *Anova test, **Kruskal‒Wallis, ***chi-square test 3.2. Differences of laboratory results between primary groups : Significant differences in fasting blood glucose, fasting insulin, insulin resistance and glycated hemoglobin levels were detected between the primary groups (p 0.05). See Table 2. 3.3. Differences of laboratory results between subgroups : When the primary groups were subdivided into subgroups, significant differences in fasting glucose, fasting insulin, insulin resistance, glycated hemoglobin, and serum levels of FTO protein were observed among the subgroups (p < 0.05). See Table 3. The variation in FTO levels across the subgroups was attributed to the difference in FTO protein levels between normal weight individuals and obese individuals without diabetes (p < 0.05). See Table 3. No significant differences in fasting insulin or serum FTO protein levels were detected between specific groups (obese individuals without diabetes or obese individuals with diabetes) and individuals (normal weight individuals without diabetes or nonobese individuals with diabetes). See Table 3 Table 3 Comparison of laboratory results between subgroups Variable Normal weight without diabetic (n = 14) Obese without diabetic (n = 22) Nonobese diabetes (n = 22) Obese diabetes (n = 22) P P 1 P 2 P 3 P 4 P 5 P 6 FBG (mg/dl) 88.74 ± 7.42 92.54 ± 4.3 213.64 ± 69.24 164.63 ± 44 0.001 c 1 0.001 0.002 0.001 0.001 0.001 FINS (uU/ml) 5.8 ± 1.7 13.17 ± 5.6 10.31 ± 5.2 17.65 ± 7.14 0.001 c 0.002 0.557 0.001 0.057 0.135 0.001 HBA1c (%) 5.4 ± 0.2 5.7 ± 0.3 9.83 ± 2.4 8.8 ± 1.9 0.001 d 1 0.001 1 0.001 0.001 0.001 HOMO IR 1.27 ± 0.4 3 ± 1.27 5.4 ± 3.1 6.47 ± 3.5 0.001 d 0.008 0.008 1.38 0.001 0.001 0.001 FTO (Pg/ml) 14.36 ± 4.5 20.83 ± 5.97 18.46 ± 7.5 17.74 ± 8 0.049 d 0.042 1 1 0.410 0.633 1 c: One -WAY ANOVA, d: Kruskal wails P1 between normal weight and obese groups. P2 between obese without diabetic and nonobese diabetes groups P3 between non obese diabetes and obese diabetes groups P4 between obese and obese diabetes groups P5 between non obese diabetes and normal weight groups. P6 between obese diabetes and normal weight group 3.4 Correlations between the serum FTO protein levels and various parameters in the primary groups : In the control group (obese and normal weight), there was a positive correlation between serum FTO protein levels and weight, BMI, WC, HP, WHtR, NC, FINS, and HOMA-IR. However, in the diabetes group, a positive correlation was observed only between age and serum levels of the FTO protein. See Table 4. Table 4 correlations between serum levels of FTO protein and various parameters in the primary study groups. Variable Control without Diabetes (n = 36) Diabetes (n = 44) r p r p Age -0.135 0.440 0.585 0.001 Weight 0.602 0.001 -0.008 0.958 BMI 0.594 0.001 0.039 0.803 WC 0.449 0.002 0.125 0.418 HP 0.555 0.001 0.017 0.915 WHR 0.180 0.302 0.158 0.307 WHtR 0.575 0.001 0.095- 0.542 NC 0.433 0.009 0.170 0.270 FBG 1 0.287 0.12 0.437 FINS 0.560 0.001 0.079- 0.611 HBA1c -0.003 0.987 0.08 0.606 HOMO IR 0.556 0.001 0.036 0.816 3.5 Correlations between FTO protein levels and laboratory parameters in subgroups : However, when the primary groups were divided into subgroups, the correlation became insignificant for most parameters in the control groups (normal weight without diabetes – obese without diabetes) (p > 0.05). The positive correlation in the diabetes subgroups (obese/nonobese) remained significant with age Table 5. Table 5 Correlations between serum levels of FTO protein and laboratory parameters in subgroups. Variable Normal weight without diabetic Obese without diabetic Nonobese diabetes Obese diabetes r p r p r p r P Age 0.355 0.234 0.287- 0.196 0.645 0.001 0.564 0.006 Weight 0.687 0.01 0.303 0.171 0.131- 0.561 0.046 0.84 BMI 0.006 0.986 0.315 0.154 -0.042 0.852 0.287 0.196 WC -0.028 0.929 0.231 0.302 -0.059 0.794 0.269 0.226 HP -0.299 0.321 0.360 1 -0.014 0.952 0.007 0.977 WHR 0.113 0.713 -0.108 0.633 -0.167 0.458 0.213 0.341 WHtR -0.437 0.135 0.064 0.778 -0.017 0.940 0.534 0.010 NC 0.738 0.004 0.26 0.256 0.476- 0.029 -0.048 0.832 FBG 0.575 0.04 -0.247 0.268 -0.90 0.691 0.157 0.487 FINS -0.115 0.707 0.336 0.126 0.018 0.93 -0.258 0.247 HBA1c -0.036 0.907 -0.067 0.767 -0.215 0.337 0.210 0.348 HOMO IR 0.044 0.887 0.305 0.167 -0.023 0.921 -0.147 0.514 4. Discussion Type 2 diabetes is considered a multifactorial metabolic disorder in which environmental, genetic, and epigenetic factors contribute to its pathogenesis. By controlling for environmental factors (such as lifestyle and diet), the influence of genetic and epigenetic factors may be mitigated. Regardless of the underlying causes of T2D, all of these causes lead to a unified pathogenic process characterized by pancreatic insufficiency in insulin secretion, along with the presence of insulin resistance [ 20 ]. The FTO protein is a nonspecific protein that is expressed abundantly in the brain and metabolic tissues [ 21 ]. FTO acts as a regulator of metabolic processes by modulating the gene expression of various genes at different stages [ 9 ]. Consequently, numerous studies have explored the relationships between FTO protein expression and metabolic disorders, including obesity, diabetes, polycystic ovarian syndrome [ 22 ], hepatic steatosis [ 23 ], and cancer [ 24]. In this context, Wang et al [ 25 ] investigated the relationship between fto gene expression and T2D severity using RT-PCR and Western blotting which included 110 individuals newly diagnosed with T2DM and 60 healthy individuals, they reported that the FTO protein was associated with type 2 diabetes severity and that the FTO protein level was correlated with obesity indices and blood glucose indices. additionally, Yang et al [ 26 ] studied 102 patients with T2D and 107 controls and reported that FTO altered the expression of genes related to glucose metabolism, resulting in the development of hyperlipidemia in T2DM patients. Another study conducted by El Gayed et al [ 27 ] which included 100 T2DM patients and 50 healthy revealed that increased FTO gene expression and its serum protein levels are associated with increased T2DM severity. In addition, previous histological and serum study conducted by Taneera et al [ 28 ] suggested that FTO plays a crucial role in β-cell survival, metabolism, and function, whereas serum FTO levels did not significantly differ between individuals with diabetes or obesity and their healthy counterparts. The aim of our study was to evaluate the serum levels of FTO protein in diabetic patients and compare them with those in a control group of nondiabetic individuals, including both obese and normal weight individuals. The samples were divided into two primary groups (diabetic/nondiabetic) to understand the association between FTO and diabetes, and since the FTO protein is related to body mass index (BMI), we further divided the primary groups based on BMI to clarify the independent associations of FTO with obesity and diabetes. Our results revealed no significant difference in serum FTO levels between the case and control groups (P = 0.618) (Table 2 ). Although FTO is known to be associated with metabolic disorders, assessment of serum levels could not fully explain these results. However, in previous serum level studies in other countries, such as the United Arab Emirates in 2024[ 28 ], FTO protein levels did not differ between the serum of diabetic patients and that of controls. Moreover, a tissue-based study within the same research area revealed a concurrent decrease in FTO gene expression in the pancreatic tissues of diabetic patients, along with a reduction in the gene expression of beta-cell proliferation genes, survival genes and insulin secretion genes. In contrast, the serum levels of FTO protein varied significantly when the primary groups were divided into subgroups (P < 0.05) (Table 3 ). This result can be attributed to the differences observed between the obese nondiabetic group and the normal weight group (P 1 = 0.042).in our study the difference may be explained by the effect of obesity, which is an inflammatory state that disrupts metabolic tissues such as the pancreas, liver, skeletal muscles and adipose tissue[ 29 ]; thus, increased serum levels of the FTO protein could reflect its overexpression in these tissues in obese individuals. Our findings did not reveal a significant difference in FTO protein levels among diabetic patients, regardless of obesity status (P > 0.05) (Tables 2 , 3 ). No previous study was divided in the same way, although metabolic dysfunction peaks, which could be attributed to pancreatic damage during the progression of the disease. According to gene view islet (data not show, see Additional file 1) and other tissues studies, FTO expression is more abundant in pancreatic cells—particularly in beta cells—than in other metabolic tissues [ 21 ]. However, during type 2 diabetes pathogenesis, some previous studies reported that FTO expression decreases, and the FTO protein might be turned over rapidly [ 30 ] or undergo methylation of the FTO gene [ 31 ] in remaining cells. This effect might be reflected in the serum levels measured. A correlation analysis between the levels of FTO protein and fasting blood glucose and HbA1c levels, as shown in Table (4), revealed that the correlation between FTO and these parameters was not significant in either the diabetic patients or the control groups (P > 0.05). According to a previous article, FTO acts as a regulator that regulates glucose metabolism via its epigenetic effects [ 32 ]. In addition, in previous serum studies investigating the relationship between FTO and blood glucose levels, a study in Egypt in 2021[ 27] reported a positive correlation in the studied sample. However, the inclusion/exclusion criteria under which the samples were selected differed from the criteria used in our study. However, in our study, elevated serum levels of FTO protein did not necessarily correlate with fasting blood glucose levels. The increase in serum levels of FTO may precede the increase in blood glucose levels at the time of T2D diagnosis, and disease progression may be associated with changes in FTO levels before diagnosis. The absence of a correlation in the control group may be due to the sample inclusion criteria. A middle-stage (prediabetic) comparison between diabetes and obesity would be helpful to clarify the relationship between FTO and fasting glucose levels. Since HbA1c reflects average blood glucose levels over the last 120 days and FTO is not associated with blood glucose levels, it is predictable that FTO is correlated indirectly with glucose levels or that our features of the samples were not significantly correlated. The serum levels of FTO protein were correlated with insulin levels and insulin resistance in the control group (P 0.05). The correlation between the FTO protein and insulin remains a subject of ongoing research. Previous histological studies have shown that elevated FTO levels cause the overexpression of several pancreatic genes, such as INS genes, thereby stimulating insulin production [ 28 ][ 30 ]. Which corresponds with insulin hypersecretion and the development of insulin resistance in the control group. Additionally, FTO influences other genes involved in insulin secretion, such as VAMP2, which is associated with the fusion and docking of insulin vesicles within the pancreas [ 28 ]. These findings may help explain the relationships among FTO protein levels, insulin levels, and insulin resistance in the control group. However, Hong-Qi et al. in MIN6 pancreatic β-cells[ 33] reported that the overexpression of FTO influenced the production of free radicals, activation of the NF-κB pathway, and subsequent endoplasmic reticulum stress in the pancreas, accompanied by mitochondrial dysfunction affecting ATP production. This excess FTO contributes to pancreatic stress, and the onset of diabetes contributes to other factors. The cells may attempt to mitigate this pathway by altering the methylation of the fto gene in the pancreas. However, our findings that serum levels of FTO vary among diabetic patients and that protein levels do not decrease uniformly. This discrepancy may be attributed to the enzymatic efficiency of the protein [ 32 ] or single nucleotide polymorphisms [ 24 ][ 29 ]. Several previous studies have investigated the relationships among FTO, insulin levels, and insulin resistance. For example, a study conducted in Egypt in 2021[ 27] revealed a correlation between serum FTO protein and insulin levels and insulin resistance in obese diabetic patients, despite differences in sample criteria and FTO protein expression was correlated with complications in obese diabetic patients; however, our study revealed that FTO protein levels were correlated with insulin resistance without disease in the control group. FTO protein was correlated with obesity indices (waist circumference, hip circumference, neck circumference, waist/height ratio, weight, and body mass index) in the control group (Table 4 ), but the correlation disappeared in the diabetic group, possibly because of changes in FTO protein levels during the pathogenesis of diabetes. In previous studies, obesity indices were related to metabolic syndrome[ 34 ][ 35 ], and a previous review[36 ] reported that FTO protein levels may be an indicator of metabolic syndrome [ 37 ] [ 38 ]. El-Gayad et al. in Egypt [ 27 ] reported a positive correlation between FTO levels in diabetes patients and obesity indices, but the study sample criteria were different. We suggest that the FTO protein is a marker for obesity a stronger than diabetes. When correlations were analyzed within subgroups, the results varied (Table 5 ). It is possible that the sample size reduced the statistical significance of these correlations or that the association between FTO and control samples appeared to be due to changes in body mass index (BMI) and the development of a general metabolic disorder, which did not affect the variables equally in the same potency. Our results also revealed a correlation between serum levels of FTO protein and age in the patient group (P 0.05) (Tables (4,5). Our findings contrast with those of some studies on the relationship between FTO and age, both in animal models and in human serum, which reported no significant effect of age on FTO protein levels. The association between FTO and age in the patient group may be attributed to the specific characteristics of the patient samples, and the exact cause remains unclear. [ 21 ]. The mean ± standard deviation of HbA 1 c for the obese-non diabetic group was 5.7 ± 0.3%, although the ADA recommended for nondiabetic individuals for HbA1c is ≤ 5.6%, but obesity [ 39 ], insulin resistance [ 40 ] and other parameters [ 41 ], which were not measured in our study, increase HbA1c; this effect is revisable when the BMI is controlled. Our study evaluated serum levels of FTO protein in type 2 diabetic patients. In light of the limitations of previous studies, we selected newly diagnosed, untreated patients receiving anti-diabetes drugs who did not suffer from any other diseases or who received treatments that might influence metabolic changes [ 27 ][ 28 ]. However, the limitations of our study include the limited sample size, the difficulty in identifying type 2 diabetic patients with normal weight and without secondary diseases, the optimal group for comparison with the nondiabetic normal weight group, the fact that almost all nonobese diabetic patients were overweight, and the lack of associations between FTO protein levels and other laboratory parameters. 5. Conclusion Serum FTO protein levels seem to be more strongly associated with obesity than with diabetes. Moreover, our findings indicate a significant correlation between FTO protein levels and insulin and insulin resistance, independent of diabetes diagnosis. Abbreviations Fat mass and obesity-associated protein: FTO Type 2 Diabetes: T2D American Diabetes Association: ADA International Diabetes Federation: IDF Turbidimetric inhibition immunoassay: TINIA Methyl-6-adenosine: m 6 A Electrochemiluminescence immunoassay: ECLIA Body mass index: BMI The waist/hip ratio: WHR Waist/height ratio: WHtR Genome-Wide Association Studies: GWAS Waist circumference: WC Hip circumference: HP Fasting insulin: FINS Fasting blood glucose: FBG Declarations Ethics approval and consent to participate: Serum samples were obtained after getting the ethical approval from the Biomedical Research Ethics Committee (BMREC) at Damascus University (February -2024) (ID number: PH-210224-210) [13] . A written informed consent was taken from each participant. Consent for publication: Not applicable. Availability of data and materials: All materials and all data generated during this study are included in this article. Competing interests: The authors declare no competing interest Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors' contributions: SIH: designed the work and revised it. HSAA collected the data and samples, performed the ELISA assay and the statistical analysis. SIH and HSAA both interpreted the results, wrote and drafted the manuscript. All authors read and approved the final manuscript. Acknowledgments: We are grateful to the endocrinologist resident doctors in the outpatient department and the staff in the laboratory department at National University Hospital in Damascus . References Banday, M. Z., Sameer, A. S., & Nissar, S. (2020). Pathophysiology of diabetes: An overview. 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Fat mass and obesity associated (FTO) gene and hepatic glucose and lipid metabolism. Nutrients, 10(11), 1600. ‏ https://doi.org/10.3390/nu10111600. Church, C., Moir, L., McMurray, F. et al. Overexpression of Fto leads to increased food intake and results in obesity. Nat Genet 42, 1086–1092 (2010). https://doi.org/10.1038/ng.713 . de Luis, D. A., Aller, R., Conde, R., Izaola, O., de la Fuente, B., & Sagrado, M. G. (2013). Relation of the rs9939609 gene variant in FTO with metabolic syndrome in obese female patients. Journal of Diabetes and its Complications, 27(4), 346-350. ‏ https://doi.org/10.1016/j.jdiacomp.2013.02.003 Damascus university, Ethical Approval for biomedical reserches,2024,(accessed 4 Novamber2024) https://www.damascusuniversity.edu.sy/srd/FCKBIH/file/%D8%B5%D9%8A%D8% AF%D9%84%D8%A9%20%D9%86%D 9%87%D8%A7%D8%A6%D9%8A%20 %D8%AC%D9%84%D8%B3%D8%A9 %2011.pdf American Diabetes Association Professional Practice Committee; 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2025. Diabetes Care 1 January 2025; 48 (Supplement_1): S27–S49. https://doi.org/10.2337/dc25-S002 World Health Organization, Body Mass Index 2024 (accessed 2 November 2025), https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index . Roche Diagnostics, Cobas HBA1c,https://assets.roche.com/f/173850/x/c16b03ef55/06378676190cobashba1c-canenvers3-a.pdf. Roche Diagnostics, Cobas FBG, gluc3_hk_2019-02_v14.pdf. Roche Diagnostics, Elecsys insulin, https://labogids.sintmaria.be/sites/default/files/insulin_2021-11_v18.pdf. My BioSource, Human ELISA KIT, FTO protein https://www.mybiosource.com/human-elisa-kits/fto/3800553. Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., Ostolaza, H., & Martín, C. (2020). Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences, 21(17), 6275. https://doi.org/10.3390/ijms21176275 . Ferenc, K., Pilžys, T., Garbicz, D., Marcinkowski, M., Skorobogatov, O., Dylewska, M., ... & Zabielski, R. (2020). Intracellular and tissue specific expression of FTO protein in pig: changes with age, energy intake and metabolic status. Scientific reports, 10(1), 13029. https://doi.org/10.1038/s41598-020-69856-5. ‏ Parveen, S., Khan, S., Moin, S., Nigar, A., Khan, M. M., & Alam, R. (2025). Association of FTO protein with hyperandrogenism metabolic disturbances in women with polycystic ovary syndrome. Endocrine Regulations, 59(1), 33-41. ‏ doi:10.2478/enr-2025-0005. [23] Andrea Lim, Jin Zhou, Rohit A. Sinha, Brijesh K. Singh, Sujoy Ghosh, Kiat-Hon Lim, Pierce Kah-Hoe Chow, Esther C.Y. Woon, Paul M. Yen Hepatic FTO expression is increased in NASH and its silencing attenuates palmitic acid-induced lipotoxicity, Biochemical and Biophysical Research Communications, Volume 479, Issue 3,2016, Pages 476-481, ISSN 0006-291X, https://doi.org/10.1016/j.bbrc.2016.09.086 , [24] Yin, D., Li, Y., Liao, X., Tian, D., Xu, Y., Zhou, C., ... & Peng, C. (2023). FTO: a critical role in obesity and obesity-related diseases. British Journal of Nutrition, 130(10), 1657-1664. DOI: https://doi.org/10.1017/S0007114523000764 ‏ . Wang Q, Wang J, Lin H, Huo X, Zhu Q, Zhang M. Relationship between fat mass and obesity-associated gene expression and type 2 diabetes mellitus severity. Exp Ther Med. 2018;15(3):2917–21. Yang, Y., Shen, F., Huang, W., Qin, S., Huang, J. T., Sergi, C., ... & Liu, S. M. (2019). Glucose is involved in the dynamic regulation of m6A in patients with type 2 diabetes. The Journal of Clinical Endocrinology & Metabolism , 104 (3), 665-673.‏ Abd El Gayed, E. M., Zewain, S. K. E. D., Ragheb, A., & ElNaidany, S. S. (2021). Fat mass and obesity-associated gene expression and disease severity in type 2 diabetes mellitus. Steroids, 174, 108897.‏ https://doi.org/10.1016/j.steroids.2021.108897 . Taneera, J., Khalique, A., Abdrabh, S., Mohammed, A. K., Bouzid, A., El-Huneidi, W., ... & Hamad, M. (2024). Fat mass and obesity-associated (FTO) gene is essential for insulin secretion and β-cell function: in vitro studies using INS-1 cells and human pancreatic islets. Life Sciences, 339, 122421. ‏ https://doi.org/10.1016/j.lfs.2024.122421 . Singla, P., Bardoloi, A., & Parkash, A. A. (2010). Metabolic effects of obesity: A review. World journal of diabetes, 1(3), 76–88. https://doi.org/10.4239/wjd.v1.i3.76 . Russell, M. A., & Morgan, N. G. (2011). Conditional expression of the FTO gene product in rat INS-1 cells reveals its rapid turnover and a role in the profile of glucose-induced insulin secretion. Clinical Science, 120(9), 403-413. ‏ https://doi.org/10.1042/CS20100416 . [31] Dayeh, T., Volkov, P., Salö, S., Hall, E., Nilsson, E., Olsson, A. H., ... & Ling, C. (2014). Genome-wide DNA methylation analysis of human pancreatic islets from type 2 diabetic and nondiabetic donors identifies candidate genes that influence insulin secretion. PLoS genetics, 10(3), e1004160. https://doi.org/10.1371/journal.pgen.1004160 . ‏ Mizuno, T. M. (2018). Fat mass and obesity associated (FTO) gene and hepatic glucose and lipid metabolism. Nutrients, 10(11), 1600. ‏ https://doi.org/10.3390/nu10111600 . Fan, H. Q., He, W., Xu, K. F., Wang, Z. X., Xu, X. Y., & Chen, H. (2015). FTO inhibits insulin secretion and promotes NF-κB activation through positively regulating ROS production in pancreatic β cells. PLoS One, 10(5), e0127705. https://doi.org/10.1371/journal.pone.0127705 ‏ Bener, A., Yousafzai, M. T., Darwish, S., Al-Hamaq, A. O., Nasralla, E. A., & Abdul-Ghani, M. (2013). Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. Journal of obesity, 2013(1), 269038. ‏ https://doi.org/10.1155/2013/269038 . Laohabut, I., Udol, K., Phisalprapa, P., Srivanichakorn, W., Chaisathaphol, T., Washirasaksiri, C., ... & Auesomwang, C. (2020). Neck circumference as a predictor of metabolic syndrome: A cross-sectional study. Primary care diabetes, 14(3), 265-273.‏ https://doi.org/10.1016/j.pcd.2019.08.007 Kucher, A. N. (2020). The FTO gene and diseases: The role of genetic polymorphism, epigenetic modifications, and environmental factors. Russian Journal of Genetics, 56(9), 1025-1043. ‏ Petkeviciene, J., Smalinskiene, A., Klumbiene, J., Petkevicius, V., Kriaucioniene, V., & Lesauskaite, V. (2016). Physical activity, but not dietary intake, attenuates the effect of the FTO rs9939609 polymorphism on obesity and metabolic syndrome in Lithuanian adult population. Public Health, 135, 23-29. https://doi.org/10.1016/j.puhe.2016.02.009 ‏‏ Fawwad, A., Siddiqui, I. A., Zeeshan, N. F., Shahid, S. M., & Basit, A. (2015). Association of SNP rs9939609 in FTO gene with metabolic syndrome in type 2 diabetic subjects, recruited from a tertiary care unit of Karachi, Pakistan. Pakistan journal of medical sciences, 31(1), 140–145. https://doi.org/10.12669/pjms.311.6524 Sheth, J., Shah, A., Sheth, F. et al. The association of dyslipidemia and obesity with glycated hemoglobin. Clin Diabetes Endocrinol 1, 6 (2015). https://doi.org/10.1186/s40842-015-0004-6 . Saha, S., Schwarz, P.E.H. Impact of glycated hemoglobin (HbA1c) on identifying insulin resistance among apparently healthy individuals. J Public Health 25, 505–512 (2017). https://doi.org/10.1007/s10389-017-0805-4 Martins, R.A., Jones, J.G., Cumming, S.P. et al. Glycated hemoglobin and associated risk factors in older adults. Cardiovasc Diabetol 11, 13 (2012). https://doi.org/10.1186/1475-2840-11-13 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8321576","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":583727338,"identity":"ff0c28cb-f90e-460d-b61e-ca929eea9550","order_by":0,"name":"Hadil Faried Shamsaldeenalsagher","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCklEQVRIiWNgGAWjYDACCRiDGYgTgJgfxEkoIEWLZAOIYUCMFhgwOAAmceswl25+9ulGjV1ifzvv0Q0Pd9jkGZ9fnfjhgQGDPL/YAaxaLOccM56dcyw5ccZhvrQbiWfSis1uvN0sAXSY4czZCVi1GNxIMGbOYTuQ2HCYx+xGYtvhxG03zm4AaUkwuI1LS/pn5px/BxLnQ7T8T9w84+zmH/i15Bgz57YdSNwA0QJk8Pduw2uL5YycYubcvmTjjRAtQE/d4N1mkWAggdMv5hLpm5lzvtnJzjt/xuzmzzZg0PWf3XzzR4WNPL80DodBaccGuJAEWCVGfGFosUcI8R/AqXoUjIJRMApGJgAAvMpoCtRxUsUAAAAASUVORK5CYII=","orcid":"","institution":"Damascus University","correspondingAuthor":true,"prefix":"","firstName":"Hadil","middleName":"Faried","lastName":"Shamsaldeenalsagher","suffix":""},{"id":583727339,"identity":"0f32030c-ec75-4d11-a6ea-c0638ef69ce7","order_by":1,"name":"Sheden Izzat Haddad","email":"","orcid":"","institution":"Damascus University","correspondingAuthor":false,"prefix":"","firstName":"Sheden","middleName":"Izzat","lastName":"Haddad","suffix":""}],"badges":[],"createdAt":"2025-12-09 23:23:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8321576/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8321576/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101658942,"identity":"5a345a1f-d96d-40fb-a40f-565a7d49e603","added_by":"auto","created_at":"2026-02-02 10:28:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1228512,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8321576/v1/f76aee71-0ce0-4356-b4ea-2f1e19018330.pdf"},{"id":101658806,"identity":"aebb77f4-b568-4a3e-b2a6-120386110eda","added_by":"auto","created_at":"2026-02-02 10:28:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":429186,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfile.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8321576/v1/7d090190b6a9310a32cb36fe.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Serum FTO Protein Levels in Newly Diagnosed Type 2 Diabetes Patients in Syria: A Case‒Control Study","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eType 2 Diabetes (T2D) is a multifactorial metabolic disorder. T2D accounts for 90\u0026ndash;95% of diabetes cases, and it is one of the most significant noncommunicable chronic diseases that seriously threatens human health. This type of diabetes is characterized by two main insulin-related abnormalities: insulin resistance and β-cell dysfunction [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. According to International Diabetes Federation (IDF) statistics for 2024, 19% of Syrians suffer from type 2 diabetes, and the number is expected to increase if the risk factors for the disease are not controlled [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Type 2 diabetes is often associated with obesity, especially visceral obesity, which leads to chronic inflammation in the body[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], contributing to the development of heart diseases, hypertension and cancer in addition to diabetes [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe \u003cem\u003efto\u003c/em\u003e gene is located on chromosome 16q12.2 and was named the \"FATSO gene\" because of its large size (approximately 410.50 kb) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The \u003cem\u003efto\u003c/em\u003e gene was originally thought to be associated with programmed cell death, several neurological diseases, growth failure, early death in children, and the phenomenon of fused fingers in embryos [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, in 2007, Genome-Wide Association Studies (GWAS) identified it as the first gene related to body mass index (BMI), so it was renamed fat mass and obesity-associated protein (FTO)[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe \u003cem\u003efto\u003c/em\u003e gene contains 8 introns and 9 exons and encodes the 2-oxoglutarate Fe\u0026thinsp;+\u0026thinsp;2-dependent AlkB family dioxygenase. Although this enzyme is involved in DNA repair and demethylation, this process is reversible [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Methyl-6-adenosine (m\u003csub\u003e6\u003c/sub\u003eA) is considered the main substrate for the FTO protein.\u003c/p\u003e \u003cp\u003eThe FTO protein is expressed in various tissues with high expression levels in the hypothalamus. FTO plays a role in posttranscriptional regulatory processes such as RNA splicing, nuclear production, degradation, and translation [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Different studies have shown the relationship between gluconeogenesis and lipogenesis [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], indicating its role in regulating appetite and metabolic processes [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe number of studies on serum FTO protein levels is limited, especially in diabetic patients, and there are no studies on FTO protein within the Syrian population. Therefore, our study aimed to assess the serum levels of FTO protein in newly diagnosed Syrian patients with type 2 diabetes. Our study is the first to assess the serum levels of FTO protein in newly diagnosed type 2 diabetic patients.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e2.1. Study design:\u003c/h2\u003e\n \u003cp\u003eThis case‒control study was conducted with 80 participants divided into two primary groups: 44 newly diagnosed diabetes patients and 36 nondiabetic individuals from the Endocrinology Department at the National University Hospital in Damascus, Syria.\u003c/p\u003e\n \u003cp\u003eThe primary study groups were further divided into subgroups \u0026quot;(four groups)\u0026quot;.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eThe case group\u003c/em\u003e was divided into two subgroups: obese diabetic patients and nonobese diabetic patients, \u003cem\u003ethe control group\u003c/em\u003e was divided into two subgroups: nondiabetic obese individuals and nondiabetic normal weight individuals.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003e2.2. Ethical considerations:\u003c/h2\u003e\n \u003cp\u003eThis study was approved by the Biomedical Research Ethics Committee at Damascus University under the number PH-210224-210 on February 2024[\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e]. A blood sample was drawn after the participants signed the consent form (one form per participant). The samples were collected between February 2024 and March 2025 at the National University Hospital in Damascus.\u003c/p\u003e\u003cspan\u003e\u003cstrong\u003e2.3. The inclusion criteria for the study groups were as follows\u003c/strong\u003e:\u003cbr\u003e\u003c/span\u003e\u003cbr\u003e-Inclusion criteria for the case group: the obese diabetic patients were newly diagnosed with T2D according to the American Diabetes Association (ADA) criteria [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e], with obesity defined by the World Health Organization (WHO) (BMI\u0026thinsp;\u0026ge;\u0026thinsp;30 kg/m\u0026sup2;) [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e]. The participants were between 38 and 65 years of age.\u003cbr\u003e\n \u003cp\u003eNonobese Diabetes patients newly diagnosed with T2D according to the ADA criteria [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e], with a BMI\u0026thinsp;\u0026le;\u0026thinsp;30 kg/m\u0026sup2; on the basis of the WHO criteria [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e]. The participants were aged between 38 and 65 years.\u003c/p\u003e\n \u003cp\u003e-Inclusion criteria for the control group:\u003c/p\u003e\n \u003cp\u003enondiabetic obese individuals: No diabetes diagnosis, obesity defined by the WHO criteria (BMI\u0026thinsp;\u0026ge;\u0026thinsp;30 kg/m\u0026sup2;) [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e], aged between 38 and 65 years.\u003c/p\u003e\n \u003cp\u003eNondiabetic normal weight individuals: No diabetes diagnosis, normal weight based on WHO criteria (BMI between 18.5 and 24.9 kg/m\u0026sup2;) [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e], aged between 38 and 65 years.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003e2.4. The Exclusion criteria for the study groups:\u003c/h2\u003e\n \u003cp\u003eIndividuals treated with insulin or antihyperglycemic agents, lipid-lowering agents, loop or thiazide diuretics, those with cardiovascular diseases, thyroid diseases, liver or kidney disorders, autoimmune diseases, infectious diseases and cancers. Women with polycystic ovary syndrome, pregnant women and breastfeeding mothers.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003e2.5. Anthropometric measurements and indices Body:\u003c/h2\u003e\n \u003cp\u003eThe participants were examined by endocrinologists, and the required research data were gathered, including a review of each participant\u0026apos;s medical history and anthropometric measurements.\u003c/p\u003e\n \u003cp\u003eWeight and height were measured via a standardized scale, with participants wearing light clothing and no shoes. Waist, hip, and neck circumferences were measured via a no stretchable measuring tape. Waist circumference (WC) was measured between the lower rib and the hip bone, passing over the navel, with the tape measure held flat against the skin without applying pressure. Hip circumference (HC) was measured at the widest point of the buttocks, also without applying pressure, with the torso upright and feet together. Neck circumference (NC) was measured with the head in a neutral position, with the tape passing across the thyroid cartilage without applying pressure.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003e2.6. Sample collection, preparation and analysis:\u003c/h2\u003e\n \u003cp\u003eAfter a 12-hour overnight fast, 6 mL of venous blood was collected from each participant via sterile venipuncture and distributed into two tubes. A 2 mL blood sample was collected in an EDTA tube, which was used for the estimation of glycated hemoglobin as a percentage of total hemoglobin, using a kit for turbidimetric inhibition immunoassay (TINIA) provided by Roche Diagnostics, Switzerland [\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e]. The remaining 4 mL of blood was placed in a clot activator tube. After blood clotting, the sample was centrifuged at 3000 \u0026times; g for 15 minutes, and a portion of the serum was collected for immediate determination of fasting blood glucose via an enzymatic colorimetric test via a Roche kit, Switzerland [\u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e]. The remaining serum was stored at \u0026minus;\u0026thinsp;80\u0026deg;C until further analysis of fasting serum insulin and serum FTO protein levels. Serum insulin levels were measured via an electrochemiluminescence immunoassay (ECLIA) via a kit provided by Roche Diagnostics, Switzerland [\u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eSerum FTO protein levels were measured via an ELISA kit provided by My BioSource, USA [\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eThe laboratory work was conducted at the National University Hospital Laboratory in Damascus.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003e2.7. Calculations:\u003c/h2\u003e\n \u003cp\u003eBody mass index (BMI) was calculated by dividing weight (kg) by the square of height (m\u0026sup2;). The waist/hip ratio (WHR) and waist/height ratio (WHtR) were subsequently calculated. Insulin resistance was determined via the HOMA-IR formula\u0026thinsp;=\u0026thinsp;fasting glucose (mg/dl) x fasting insulin (\u0026micro;U/mL)/405.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003e2.8. Statistical analysis:\u003c/h2\u003e\n \u003cp\u003eThe data were manually collected in an Excel spreadsheet. Statistical analyses and study correlations were performed via IBM SPSS Statistics version 27. Numerical data are expressed as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation for normally distributed samples and as the median\u0026thinsp;\u0026plusmn;\u0026thinsp;interquartile range for nonnormally distributed samples. Numerical variables were compared between primary groups via the Mann‒Whitney test and the independent t test. For comparisons between subgroups, ANOVA and the Kruskal‒Wallis test were used, depending on the sample distribution pattern. The chi-square test was used for categorical variables. Correlations were assessed via Pearson\u0026rsquo;s test for the primary groups and via Spearman\u0026rsquo;s test for the subgroups. A p value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Demographic and anthropometric parameters\u003c/strong\u003e:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eThis study was a case‒control study that included 44 newly diagnosed individuals with T2D and 36 control participants without diabetes (22 obese and 14 normal weight individuals). There were no significant differences between the groups in terms of age or sex (p \u0026gt; 0.05).\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eDifferences between groups: Significant differences were observed between the subgroups (normal weight without diabetes, obese without diabetes, nonobese diabetes and obese diabetes) in terms of weight, BMI, WC, HP, NC, Waist/hip ratio (WHR), and Waist/height ratio (WHtR) (p \u0026lt; 0.001). However, no differences in any of the demographic parameters were found between the obese without diabetes group and the obese with diabetes group (p \u0026gt; 0.05). See Table\u0026nbsp;1\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 1\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eDemographic and anthropometric parameters of the studied group.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"12\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNormal weight without diabetic (n = 14)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eObese\u003c/p\u003e\n \u003cp\u003ewithout\u003c/p\u003e\n \u003cp\u003ediabetic\u003c/p\u003e\n \u003cp\u003e(n = 22)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNon\u003c/p\u003e\n \u003cp\u003eobese diabetes (n = 22)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eObese diabetes (n = 22)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP3\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP4\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP5\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP6\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.38 ± 6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.45 ± 6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.5 ± 6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.1 ± 6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.057\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.539\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003esex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.173\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7(50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10(45.45%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17(77.27%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12(54.54%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7(50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12(54.54%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5(22.72%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10(45.45%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58 ± 6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100 ± 15.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77.35 ± 11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e102.1 ± 16.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeight(m)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e164.3 ± 9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e166.36 ± 11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e169.18 ± 10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e166.68 ± 9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.637\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI) kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.38 ± 1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.7 ± 4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.9 ± 2.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.8 ± 7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.778\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.3 ± 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e112.14 ± 1.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.9 ± 6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e116.77 ± 10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e93.46 ± 4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e120.64 ± 6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e104.55 ± 5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e118.1 ± 11.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWHR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.85 ± 0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.93 ± 0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.96 ± 0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.99 ± 0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWHtR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.48 ± 0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.67 ± 0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.59 ± 0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.7 ± 0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.603\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.15 ± 1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.1 ± 4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.71 ± 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.8 ± 3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"12\"\u003e\n \u003cp\u003eBMI: Body Mass Index, WC: Waist Circumference, HC: Hip Circumference, WHR: Waist/Hip Ratio, WHtR: Waist/Height Ratio, NC: Neck Circumference\u003c/p\u003e\n \u003cp\u003eP1 between normal weight and obese groups.\u003c/p\u003e\n \u003cp\u003eP2 between obese without diabetic and nonobese diabetes groups\u003c/p\u003e\n \u003cp\u003eP3 between non obese diabetes and obese diabetes groups\u003c/p\u003e\n \u003cp\u003eP4 between obese and obese diabetes groups\u003c/p\u003e\n \u003cp\u003eP5 between non obese diabetes and normal weight groups.\u003c/p\u003e\n \u003cp\u003eP6 between obese diabetes and normal weight groups.\u003c/p\u003e\n \u003cp\u003e*Anova test, **Kruskal‒Wallis, ***chi-square test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e3.2. Differences of laboratory results between primary groups\u003c/strong\u003e:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eSignificant differences in fasting blood glucose, fasting insulin, insulin resistance and glycated hemoglobin levels were detected between the primary groups (p \u0026lt; 0.05). However, the serum levels of the FTO protein did not differ between the primary groups (p \u0026gt; 0.05). See Table\u0026nbsp;2.\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cdiv\u003e\n \u003cdiv align=\"left\"\u003e\u003cbr\u003e\u003cimg 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\"\u003e\u003c/div\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e3.3. Differences of laboratory results between subgroups\u003c/strong\u003e:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eWhen the primary groups were subdivided into subgroups, significant differences in fasting glucose, fasting insulin, insulin resistance, glycated hemoglobin, and serum levels of FTO protein were observed among the subgroups (p \u0026lt; 0.05). See Table\u0026nbsp;3.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eThe variation in FTO levels across the subgroups was attributed to the difference in FTO protein levels between normal weight individuals and obese individuals without diabetes (p \u0026lt; 0.05). See Table\u0026nbsp;3.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eNo significant differences in fasting insulin or serum FTO protein levels were detected between specific groups (obese individuals without diabetes or obese individuals with diabetes) and individuals (normal weight individuals without diabetes or nonobese individuals with diabetes). See Table\u0026nbsp;3\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 3\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eComparison of laboratory results between subgroups\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"12\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNormal weight\u003c/p\u003e\n \u003cp\u003ewithout diabetic (n = 14)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eObese without diabetic\u003c/p\u003e\n \u003cp\u003e(n = 22)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNonobese diabetes (n = 22)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eObese diabetes (n = 22)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003csub\u003e3\u003c/sub\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003csub\u003e5\u003c/sub\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003csub\u003e6\u003c/sub\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFBG (mg/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88.74 ± 7.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92.54 ± 4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e213.64 ± 69.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e164.63 ± 44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFINS (uU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.8 ± 1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.17 ± 5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.31 ± 5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.65 ± 7.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.557\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHBA1c (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.4 ± 0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.7 ± 0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.83 ± 2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.8 ± 1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHOMO IR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.27 ± 0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 ± 1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.4 ± 3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.47 ± 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFTO (Pg/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.36 ± 4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.83 ± 5.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.46 ± 7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.74 ± 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.049\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.410\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.633\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"12\"\u003e\n \u003cp\u003ec: One -WAY ANOVA, d: Kruskal wails\u003c/p\u003e\n \u003cp\u003eP1 between normal weight and obese groups.\u003c/p\u003e\n \u003cp\u003eP2 between obese without diabetic and nonobese diabetes groups\u003c/p\u003e\n \u003cp\u003eP3 between non obese diabetes and obese diabetes groups\u003c/p\u003e\n \u003cp\u003eP4 between obese and obese diabetes groups\u003c/p\u003e\n \u003cp\u003eP5 between non obese diabetes and normal weight groups.\u003c/p\u003e\n \u003cp\u003eP6 between obese diabetes and normal weight group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Correlations between the serum FTO protein levels and various parameters in the primary groups\u003c/strong\u003e:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eIn the control group (obese and normal weight), there was a positive correlation between serum FTO protein levels and weight, BMI, WC, HP, WHtR, NC, FINS, and HOMA-IR. However, in the diabetes group, a positive correlation was observed only between age and serum levels of the FTO protein. See Table\u0026nbsp;4.\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 4\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ecorrelations between serum levels of FTO protein and various parameters in the primary study groups.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eControl without Diabetes\u003c/p\u003e\n \u003cp\u003e(n = 36)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003cp\u003e(n = 44)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.440\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.602\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.958\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.594\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.803\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.449\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.418\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.915\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWHR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.307\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWHtR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.575\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.095-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.542\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.433\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.170\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.270\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFBG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.437\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFINS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.560\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.079-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.611\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHBA1c\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.987\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.606\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHOMO IR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.556\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.816\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e3.5 Correlations between FTO protein levels and laboratory parameters in subgroups\u003c/strong\u003e:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eHowever, when the primary groups were divided into subgroups, the correlation became insignificant for most parameters in the control groups (normal weight without diabetes – obese without diabetes) (p \u0026gt; 0.05). The positive correlation in the diabetes subgroups (obese/nonobese) remained significant with age Table\u0026nbsp;5.\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 5\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eCorrelations between serum levels of FTO protein and laboratory parameters in subgroups.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"9\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eNormal weight\u003c/p\u003e\n \u003cp\u003ewithout diabetic\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eObese without diabetic\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eNonobese diabetes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eObese diabetes\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.287-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.645\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.687\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.303\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.131-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.561\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.046\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.986\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.852\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.196\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.929\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.794\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.269\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.226\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.321\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.977\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWHR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.633\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.341\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWHtR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.778\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.940\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.534\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.738\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.476-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.832\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFBG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.575\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.268\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.487\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFINS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.707\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.336\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.258\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.247\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHBA1c\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.907\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.767\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.337\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.348\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHOMO IR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.921\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.514\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eType 2 diabetes is considered a multifactorial metabolic disorder in which environmental, genetic, and epigenetic factors contribute to its pathogenesis. By controlling for environmental factors (such as lifestyle and diet), the influence of genetic and epigenetic factors may be mitigated. Regardless of the underlying causes of T2D, all of these causes lead to a unified pathogenic process characterized by pancreatic insufficiency in insulin secretion, along with the presence of insulin resistance [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe FTO protein is a nonspecific protein that is expressed abundantly in the brain and metabolic tissues [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. FTO acts as a regulator of metabolic processes by modulating the gene expression of various genes at different stages [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Consequently, numerous studies have explored the relationships between FTO protein expression and metabolic disorders, including obesity, diabetes, polycystic ovarian syndrome [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], hepatic steatosis [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], and cancer [ 24].\u003c/p\u003e \u003cp\u003eIn this context, Wang et al [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] investigated the relationship between fto gene expression and T2D severity using RT-PCR and Western blotting which included 110 individuals newly diagnosed with T2DM and 60 healthy individuals, they reported that the FTO protein was associated with type 2 diabetes severity and that the FTO protein level was correlated with obesity indices and blood glucose indices. additionally, Yang et al [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] studied 102 patients with T2D and 107 controls and reported that FTO altered the expression of genes related to glucose metabolism, resulting in the development of hyperlipidemia in T2DM patients. Another study conducted by El Gayed et al [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] which included 100 T2DM patients and 50 healthy revealed that increased FTO gene expression and its serum protein levels are associated with increased T2DM severity. In addition, previous histological and serum study conducted by Taneera et al [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] suggested that FTO plays a crucial role in β-cell survival, metabolism, and function, whereas serum FTO levels did not significantly differ between individuals with diabetes or obesity and their healthy counterparts.\u003c/p\u003e \u003cp\u003eThe aim of our study was to evaluate the serum levels of FTO protein in diabetic patients and compare them with those in a control group of nondiabetic individuals, including both obese and normal weight individuals. The samples were divided into two primary groups (diabetic/nondiabetic) to understand the association between FTO and diabetes, and since the FTO protein is related to body mass index (BMI), we further divided the primary groups based on BMI to clarify the independent associations of FTO with obesity and diabetes.\u003c/p\u003e \u003cp\u003eOur results revealed no significant difference in serum FTO levels between the case and control groups (P\u0026thinsp;=\u0026thinsp;0.618) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Although FTO is known to be associated with metabolic disorders, assessment of serum levels could not fully explain these results. However, in previous serum level studies in other countries, such as the United Arab Emirates in 2024[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], FTO protein levels did not differ between the serum of diabetic patients and that of controls. Moreover, a tissue-based study within the same research area revealed a concurrent decrease in FTO gene expression in the pancreatic tissues of diabetic patients, along with a reduction in the gene expression of beta-cell proliferation genes, survival genes and insulin secretion genes.\u003c/p\u003e \u003cp\u003eIn contrast, the serum levels of FTO protein varied significantly when the primary groups were divided into subgroups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). This result can be attributed to the differences observed between the obese nondiabetic group and the normal weight group (P\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.042).in our study the difference may be explained by the effect of obesity, which is an inflammatory state that disrupts metabolic tissues such as the pancreas, liver, skeletal muscles and adipose tissue[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]; thus, increased serum levels of the FTO protein could reflect its overexpression in these tissues in obese individuals.\u003c/p\u003e \u003cp\u003eOur findings did not reveal a significant difference in FTO protein levels among diabetic patients, regardless of obesity status (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). No previous study was divided in the same way, although metabolic dysfunction peaks, which could be attributed to pancreatic damage during the progression of the disease. According to gene view islet (data not show, see Additional file 1) and other tissues studies, FTO expression is more abundant in pancreatic cells\u0026mdash;particularly in beta cells\u0026mdash;than in other metabolic tissues [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. However, during type 2 diabetes pathogenesis, some previous studies reported that FTO expression decreases, and the FTO protein might be turned over rapidly [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] or undergo methylation of the FTO gene [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] in remaining cells. This effect might be reflected in the serum levels measured.\u003c/p\u003e \u003cp\u003eA correlation analysis between the levels of FTO protein and fasting blood glucose and HbA1c levels, as shown in Table\u0026nbsp;(4), revealed that the correlation between FTO and these parameters was not significant in either the diabetic patients or the control groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). According to a previous article, FTO acts as a regulator that regulates glucose metabolism via its epigenetic effects [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. In addition, in previous serum studies investigating the relationship between FTO and blood glucose levels, a study in Egypt in 2021[ 27] reported a positive correlation in the studied sample. However, the inclusion/exclusion criteria under which the samples were selected differed from the criteria used in our study.\u003c/p\u003e \u003cp\u003eHowever, in our study, elevated serum levels of FTO protein did not necessarily correlate with fasting blood glucose levels. The increase in serum levels of FTO may precede the increase in blood glucose levels at the time of T2D diagnosis, and disease progression may be associated with changes in FTO levels before diagnosis. The absence of a correlation in the control group may be due to the sample inclusion criteria. A middle-stage (prediabetic) comparison between diabetes and obesity would be helpful to clarify the relationship between FTO and fasting glucose levels.\u003c/p\u003e \u003cp\u003eSince HbA1c reflects average blood glucose levels over the last 120 days and FTO is not associated with blood glucose levels, it is predictable that FTO is correlated indirectly with glucose levels or that our features of the samples were not significantly correlated.\u003c/p\u003e \u003cp\u003eThe serum levels of FTO protein were correlated with insulin levels and insulin resistance in the control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e), but the correlation was not significant in the diabetic patient group (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The correlation between the FTO protein and insulin remains a subject of ongoing research. Previous histological studies have shown that elevated FTO levels cause the overexpression of several pancreatic genes, such as INS genes, thereby stimulating insulin production [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e][\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Which corresponds with insulin hypersecretion and the development of insulin resistance in the control group. Additionally, FTO influences other genes involved in insulin secretion, such as VAMP2, which is associated with the fusion and docking of insulin vesicles within the pancreas [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. These findings may help explain the relationships among FTO protein levels, insulin levels, and insulin resistance in the control group.\u003c/p\u003e \u003cp\u003eHowever, Hong-Qi et al. in MIN6 pancreatic β-cells[ 33] reported that the overexpression of FTO influenced the production of free radicals, activation of the NF-κB pathway, and subsequent endoplasmic reticulum stress in the pancreas, accompanied by mitochondrial dysfunction affecting ATP production. This excess FTO contributes to pancreatic stress, and the onset of diabetes contributes to other factors. The cells may attempt to mitigate this pathway by altering the methylation of the \u003cem\u003efto\u003c/em\u003e gene in the pancreas. However, our findings that serum levels of FTO vary among diabetic patients and that protein levels do not decrease uniformly. This discrepancy may be attributed to the enzymatic efficiency of the protein [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] or single nucleotide polymorphisms [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e][\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral previous studies have investigated the relationships among FTO, insulin levels, and insulin resistance. For example, a study conducted in Egypt in 2021[ 27] revealed a correlation between serum FTO protein and insulin levels and insulin resistance in obese diabetic patients, despite differences in sample criteria and FTO protein expression was correlated with complications in obese diabetic patients; however, our study revealed that FTO protein levels were correlated with insulin resistance without disease in the control group.\u003c/p\u003e \u003cp\u003eFTO protein was correlated with obesity indices (waist circumference, hip circumference, neck circumference, waist/height ratio, weight, and body mass index) in the control group (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e), but the correlation disappeared in the diabetic group, possibly because of changes in FTO protein levels during the pathogenesis of diabetes. In previous studies, obesity indices were related to metabolic syndrome[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e][\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], and a previous review[36 ] reported that FTO protein levels may be an indicator of metabolic syndrome [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. El-Gayad et al. in Egypt [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] reported a positive correlation between FTO levels in diabetes patients and obesity indices, but the study sample criteria were different. We suggest that the FTO protein is a marker for obesity a stronger than diabetes.\u003c/p\u003e \u003cp\u003eWhen correlations were analyzed within subgroups, the results varied (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). It is possible that the sample size reduced the statistical significance of these correlations or that the association between FTO and control samples appeared to be due to changes in body mass index (BMI) and the development of a general metabolic disorder, which did not affect the variables equally in the same potency.\u003c/p\u003e \u003cp\u003eOur results also revealed a correlation between serum levels of FTO protein and age in the patient group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), whereas no such correlation was observed in the control group (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Tables\u0026nbsp;(4,5). Our findings contrast with those of some studies on the relationship between FTO and age, both in animal models and in human serum, which reported no significant effect of age on FTO protein levels. The association between FTO and age in the patient group may be attributed to the specific characteristics of the patient samples, and the exact cause remains unclear. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation of HbA\u003csub\u003e1\u003c/sub\u003ec for the obese-non diabetic group was 5.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3%, although the ADA recommended for nondiabetic individuals for HbA1c is \u0026le;\u0026thinsp;5.6%, but obesity [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], insulin resistance [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] and other parameters [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], which were not measured in our study, increase HbA1c; this effect is revisable when the BMI is controlled.\u003c/p\u003e \u003cp\u003eOur study evaluated serum levels of FTO protein in type 2 diabetic patients. In light of the limitations of previous studies, we selected newly diagnosed, untreated patients receiving anti-diabetes drugs who did not suffer from any other diseases or who received treatments that might influence metabolic changes [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e][\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. However, the limitations of our study include the limited sample size, the difficulty in identifying type 2 diabetic patients with normal weight and without secondary diseases, the optimal group for comparison with the nondiabetic normal weight group, the fact that almost all nonobese diabetic patients were overweight, and the lack of associations between FTO protein levels and other laboratory parameters.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eSerum FTO protein levels seem to be more strongly associated with obesity than with diabetes. Moreover, our findings indicate a significant correlation between FTO protein levels and insulin and insulin resistance, independent of diabetes diagnosis.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eFat mass and obesity-associated protein: FTO Type 2 Diabetes: T2D \u003c/p\u003e\n\u003cp\u003eAmerican Diabetes Association: ADA International Diabetes Federation: IDF \u003c/p\u003e\n\u003cp\u003eTurbidimetric inhibition immunoassay: TINIA Methyl-6-adenosine: m\u003csub\u003e6\u003c/sub\u003eA \u003c/p\u003e\n\u003cp\u003eElectrochemiluminescence immunoassay: ECLIA Body mass index: BMI \u003c/p\u003e\n\u003cp\u003eThe waist/hip ratio: WHR Waist/height ratio: WHtR \u003c/p\u003e\n\u003cp\u003eGenome-Wide Association Studies: GWAS Waist circumference: WC \u003c/p\u003e\n\u003cp\u003eHip circumference: HP Fasting insulin: FINS \u003c/p\u003e\n\u003cp\u003eFasting blood glucose: FBG\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u0026nbsp;\u003c/strong\u003eSerum samples were obtained after getting the ethical approval from the Biomedical Research Ethics Committee (BMREC) at Damascus University (February -2024) (ID number: PH-210224-210) \u003ca href=\"#REF13\"\u003e[13]\u003c/a\u003e. A written informed consent was taken from each participant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eAll materials and all data generated during this study are included in this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare no competing interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/strong\u003eSIH: designed the work and revised it. HSAA collected the data and samples, performed the ELISA assay and the statistical analysis. SIH and HSAA both interpreted the results, wrote and drafted the manuscript. All authors read and approved the final \u0026nbsp;\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cspan dir=\"LTR\"\u003emanuscript.\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e We are grateful to the endocrinologist resident doctors in the outpatient department and the staff in the laboratory department at National University Hospital in Damascus\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBanday, M. Z., Sameer, A. S., \u0026amp; Nissar, S. (2020). Pathophysiology of diabetes: An overview. Avicenna journal of medicine, 10(4), 174\u0026ndash;188. https://doi.org/10.4103/ajm.ajm_53_20\u003c/li\u003e\n\u003cli\u003eInternational Diabetes Federation, Diabetes statistics reports for Syrian Arab Repuplic,2024(accessed 2 November 2025) https://diabetesatlas.org/data-by-location/country/syrian-arab-republic/.\u003c/li\u003e\n\u003cli\u003eGalicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., Ostolaza, H., \u0026amp; Mart\u0026iacute;n, C. (2020). Pathophysiology of Type 2 Diabetes Mellitus. International journal of molecular sciences, 21(17), 6275. https://doi.org/10.3390/ijms21176275 \u003c/li\u003e\n\u003cli\u003eUllah, M. I., \u0026amp; Tamanna, S. (2025). Obesity: Clinical Impact, Pathophysiology, Complications, and Modern Innovations in Therapeutic Strategies. Medicines, 12(3), 19.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.3390/medicines12030019 .\u003c/li\u003e\n\u003cli\u003eKucher, A.N. The FTO Gene and Diseases: The Role of Genetic Polymorphism, Epigenetic Modifications, and Environmental Factors. Russ J Genet 56, 1025\u0026ndash;1043 (2020). https://doi.org/10.1134/S1022795420090136.\u003c/li\u003e\n\u003cli\u003eYang, Q., Xiao, T., Guo, J., \u0026amp; Su, Z. (2017). Complex Relationship between Obesity and the Fat Mass and Obesity Locus. International journal of biological sciences, 13(5), 615\u0026ndash;629. https://doi.org/10.7150/ijbs.17051 .\u003c/li\u003e\n\u003cli\u003eYin, D., Li, Y., Liao, X., Tian, D., Xu, Y., Zhou, C., ... \u0026amp; Peng, C. (2023). FTO: a critical role in obesity and obesity-related diseases. British Journal of Nutrition, 130(10), 1657-1664.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.1017/S0007114523000764.\u003c/li\u003e\n\u003cli\u003eYang, Z., Yu, G. L., Zhu, X., Peng, T. H., \u0026amp; Lv, Y. C. (2022). Critical roles of FTO-mediated mRNA m6A demethylation in regulating adipogenesis and lipid metabolism: implications in lipid metabolic disorders. Genes \u0026amp; diseases, 9(1), 51-61.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.1016/j.gendis.2021.01.005 .\u003c/li\u003e\n\u003cli\u003eLan, N., Lu, Y., Zhang, Y., Pu, S., Xi, H., Nie, X., ... \u0026amp; Yuan, W. (2020). FTO\u0026ndash;a common genetic basis for obesity and cancer. Frontiers in genetics, 11, 559138.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.3389/fgene.2020.559138.\u003c/li\u003e\n\u003cli\u003eMizuno, T. M. (2018). Fat mass and obesity associated (FTO) gene and hepatic glucose and lipid metabolism. Nutrients, 10(11), 1600.\u003cspan dir=\"RTL\"\u003e\u0026rlm; https://doi.org/10.3390/nu10111600.\u003c/span\u003e\u003c/li\u003e\n\u003cli\u003eChurch, C., Moir, L., McMurray, F. et al. Overexpression of Fto leads to increased food intake and results in obesity. Nat Genet 42, 1086\u0026ndash;1092 (2010). https://doi.org/10.1038/ng.713 .\u003c/li\u003e\n\u003cli\u003ede Luis, D. A., Aller, R., Conde, R., Izaola, O., de la Fuente, B., \u0026amp; Sagrado, M. G. (2013). Relation of the rs9939609 gene variant in FTO with metabolic syndrome in obese female patients. Journal of Diabetes and its Complications, 27(4), 346-350.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.1016/j.jdiacomp.2013.02.003 \u003c/li\u003e\n\u003cli\u003eDamascus university, Ethical Approval for biomedical reserches,2024,(accessed 4 Novamber2024) https://www.damascusuniversity.edu.sy/srd/FCKBIH/file/%D8%B5%D9%8A%D8%\nAF%D9%84%D8%A9%20%D9%86%D\n9%87%D8%A7%D8%A6%D9%8A%20\n%D8%AC%D9%84%D8%B3%D8%A9\n%2011.pdf \u003c/li\u003e\n\u003cli\u003eAmerican Diabetes Association Professional Practice Committee; 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes\u0026mdash;2025. \u003cem\u003eDiabetes Care\u003c/em\u003e 1 January 2025; 48 (Supplement_1): S27\u0026ndash;S49. https://doi.org/10.2337/dc25-S002 \u003c/li\u003e\n\u003cli\u003eWorld Health Organization, Body Mass Index 2024 (accessed 2 November 2025), https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index .\u003c/li\u003e\n\u003cli\u003eRoche Diagnostics, Cobas HBA1c,https://assets.roche.com/f/173850/x/c16b03ef55/06378676190cobashba1c-canenvers3-a.pdf.\u003c/li\u003e\n\u003cli\u003eRoche Diagnostics, Cobas FBG, gluc3_hk_2019-02_v14.pdf.\u003c/li\u003e\n\u003cli\u003eRoche Diagnostics, Elecsys insulin, https://labogids.sintmaria.be/sites/default/files/insulin_2021-11_v18.pdf.\u003c/li\u003e\n\u003cli\u003eMy BioSource, Human ELISA KIT, FTO protein https://www.mybiosource.com/human-elisa-kits/fto/3800553.\u003c/li\u003e\n\u003cli\u003eGalicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., Ostolaza, H., \u0026amp; Mart\u0026iacute;n, C. (2020). Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences, 21(17), 6275. https://doi.org/10.3390/ijms21176275 .\u003c/li\u003e\n\u003cli\u003eFerenc, K., Pilžys, T., Garbicz, D., Marcinkowski, M., Skorobogatov, O., Dylewska, M., ... \u0026amp; Zabielski, R. (2020). Intracellular and tissue specific expression of FTO protein in pig: changes with age, energy intake and metabolic status. Scientific reports, 10(1), 13029. https://doi.org/10.1038/s41598-020-69856-5. \u003cspan dir=\"RTL\"\u003e\u0026rlm;\u003c/span\u003e\u003c/li\u003e\n\u003cli\u003eParveen, S., Khan, S., Moin, S., Nigar, A., Khan, M. M., \u0026amp; Alam, R. (2025). Association of FTO protein with hyperandrogenism metabolic disturbances in women with polycystic ovary syndrome. Endocrine Regulations, 59(1), 33-41.\u003cspan dir=\"RTL\"\u003e\u0026rlm; doi:10.2478/enr-2025-0005.\u003c/span\u003e\u003c/li\u003e\n\u003cli\u003e\u003cspan dir=\"LTR\"\u003e[23] Andrea Lim, Jin Zhou, Rohit A. Sinha, Brijesh K. Singh, Sujoy Ghosh, Kiat-Hon Lim, Pierce Kah-Hoe Chow, Esther C.Y. Woon, Paul M. Yen Hepatic FTO expression is increased in NASH and its silencing attenuates palmitic acid-induced lipotoxicity, Biochemical and Biophysical Research Communications, Volume 479, Issue 3,2016, Pages 476-481, ISSN 0006-291X, \u003c/span\u003e\u003cspan dir=\"LTR\"\u003ehttps://doi.org/10.1016/j.bbrc.2016.09.086\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e \u003c/span\u003e,\u003c/li\u003e\n\u003cli\u003e\u003cspan dir=\"LTR\"\u003e[24] \u003c/span\u003e\u003cspan dir=\"LTR\"\u003eYin, D., Li, Y., Liao, X., Tian, D., Xu, Y., Zhou, C., ... \u0026amp; Peng, C. (2023). FTO: a critical role in obesity and obesity-related diseases. British Journal of Nutrition, 130(10), 1657-1664. DOI: \u003c/span\u003e\u003cspan dir=\"LTR\"\u003ehttps://doi.org/10.1017/S0007114523000764\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e \u003c/span\u003e\u0026rlm;\u003cspan dir=\"LTR\"\u003e.\u003c/span\u003e\u003c/li\u003e\n\u003cli\u003eWang Q, Wang J, Lin H, Huo X, Zhu Q, Zhang M. Relationship between fat mass and obesity-associated gene expression and type 2 diabetes mellitus severity. Exp Ther Med. 2018;15(3):2917\u0026ndash;21. \u003c/li\u003e\n\u003cli\u003eYang, Y., Shen, F., Huang, W., Qin, S., Huang, J. T., Sergi, C., ... \u0026amp; Liu, S. M. (2019). Glucose is involved in the dynamic regulation of m6A in patients with type 2 diabetes. \u003cem\u003eThe Journal of Clinical Endocrinology \u0026amp; Metabolism\u003c/em\u003e, \u003cem\u003e104\u003c/em\u003e(3), 665-673.\u0026rlm;\u003c/li\u003e\n\u003cli\u003eAbd El Gayed, E. M., Zewain, S. K. E. D., Ragheb, A., \u0026amp; ElNaidany, S. S. (2021). Fat mass and obesity-associated gene expression and disease severity in type 2 diabetes mellitus. Steroids, 174, 108897.\u0026rlm; https://doi.org/10.1016/j.steroids.2021.108897 .\u003c/li\u003e\n\u003cli\u003eTaneera, J., Khalique, A., Abdrabh, S., Mohammed, A. K., Bouzid, A., El-Huneidi, W., ... \u0026amp; Hamad, M. (2024). Fat mass and obesity-associated (FTO) gene is essential for insulin secretion and \u0026beta;-cell function: in vitro studies using INS-1 cells and human pancreatic islets. Life Sciences, 339, 122421.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.1016/j.lfs.2024.122421 .\u003c/li\u003e\n\u003cli\u003eSingla, P., Bardoloi, A., \u0026amp; Parkash, A. A. (2010). Metabolic effects of obesity: A review. World journal of diabetes, 1(3), 76\u0026ndash;88. https://doi.org/10.4239/wjd.v1.i3.76 .\u003c/li\u003e\n\u003cli\u003eRussell, M. A., \u0026amp; Morgan, N. G. (2011). Conditional expression of the FTO gene product in rat INS-1 cells reveals its rapid turnover and a role in the profile of glucose-induced insulin secretion. Clinical Science, 120(9), 403-413.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.1042/CS20100416 .\u003c/li\u003e\n\u003cli\u003e\u003cspan dir=\"LTR\"\u003e[31] Dayeh, T., Volkov, P., Sal\u0026ouml;, S., Hall, E., Nilsson, E., Olsson, A. H., ... \u0026amp; Ling, C. (2014). Genome-wide DNA methylation analysis of human pancreatic islets from type 2 diabetic and nondiabetic donors identifies candidate genes that influence insulin secretion. PLoS genetics, 10(3), e1004160. \u003c/span\u003e\u003cspan dir=\"LTR\"\u003ehttps://doi.org/10.1371/journal.pgen.1004160\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e \u003c/span\u003e\u003cspan dir=\"LTR\"\u003e. \u0026rlm;\u003c/span\u003e\u003c/li\u003e\n\u003cli\u003eMizuno, T. M. (2018). Fat mass and obesity associated (FTO) gene and hepatic glucose and lipid metabolism. Nutrients, 10(11), 1600.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.3390/nu10111600 .\u003c/li\u003e\n\u003cli\u003eFan, H. Q., He, W., Xu, K. F., Wang, Z. X., Xu, X. Y., \u0026amp; Chen, H. (2015). FTO inhibits insulin secretion and promotes NF-\u0026kappa;B activation through positively regulating ROS production in pancreatic \u0026beta; cells. PLoS One, 10(5), e0127705. https://doi.org/10.1371/journal.pone.0127705 \u0026rlm; \u003c/li\u003e\n\u003cli\u003eBener, A., Yousafzai, M. T., Darwish, S., Al-Hamaq, A. O., Nasralla, E. A., \u0026amp; Abdul-Ghani, M. (2013). Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. Journal of obesity, 2013(1), 269038.\u003cspan dir=\"RTL\"\u003e\u0026rlm; \u003c/span\u003ehttps://doi.org/10.1155/2013/269038 .\u003c/li\u003e\n\u003cli\u003eLaohabut, I., Udol, K., Phisalprapa, P., Srivanichakorn, W., Chaisathaphol, T., Washirasaksiri, C., ... \u0026amp; Auesomwang, C. (2020). Neck circumference as a predictor of metabolic syndrome: A cross-sectional study. Primary care diabetes, 14(3), 265-273.\u0026rlm; https://doi.org/10.1016/j.pcd.2019.08.007 \u003c/li\u003e\n\u003cli\u003eKucher, A. N. (2020). The FTO gene and diseases: The role of genetic polymorphism, epigenetic modifications, and environmental factors. Russian Journal of Genetics, 56(9), 1025-1043.\u003cspan dir=\"RTL\"\u003e\u0026rlm;\u003c/span\u003e\u003c/li\u003e\n\u003cli\u003ePetkeviciene, J., Smalinskiene, A., Klumbiene, J., Petkevicius, V., Kriaucioniene, V., \u0026amp; Lesauskaite, V. (2016). Physical activity, but not dietary intake, attenuates the effect of the FTO rs9939609 polymorphism on obesity and metabolic syndrome in Lithuanian adult population. Public Health, 135, 23-29. https://doi.org/10.1016/j.puhe.2016.02.009\u003cspan dir=\"RTL\"\u003e\u0026rlm;\u0026rlm;\u003c/span\u003e\u003c/li\u003e\n\u003cli\u003eFawwad, A., Siddiqui, I. A., Zeeshan, N. F., Shahid, S. M., \u0026amp; Basit, A. (2015). Association of SNP rs9939609 in FTO gene with metabolic syndrome in type 2 diabetic subjects, recruited from a tertiary care unit of Karachi, Pakistan. Pakistan journal of medical sciences, 31(1), 140\u0026ndash;145. https://doi.org/10.12669/pjms.311.6524 \u003c/li\u003e\n\u003cli\u003eSheth, J., Shah, A., Sheth, F. et al. The association of dyslipidemia and obesity with glycated hemoglobin. Clin Diabetes Endocrinol 1, 6 (2015). https://doi.org/10.1186/s40842-015-0004-6 .\u003c/li\u003e\n\u003cli\u003eSaha, S., Schwarz, P.E.H. Impact of glycated hemoglobin (HbA1c) on identifying insulin resistance among apparently healthy individuals. J Public Health 25, 505\u0026ndash;512 (2017). https://doi.org/10.1007/s10389-017-0805-4 \u003c/li\u003e\n\u003cli\u003eMartins, R.A., Jones, J.G., Cumming, S.P. et al. Glycated hemoglobin and associated risk factors in older adults. Cardiovasc Diabetol 11, 13 (2012). https://doi.org/10.1186/1475-2840-11-13\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-endocrine-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bend","sideBox":"Learn more about [BMC Endocrine Disorders](http://bmcendocrdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bend/default.aspx","title":"BMC Endocrine Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Type 2 diabetes, obesity, FTO protein, insulin, insulin resistance, Syrians","lastPublishedDoi":"10.21203/rs.3.rs-8321576/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8321576/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003eType 2 diabetes is often accompanied by obesity, particularly visceral obesity. On the other hand, The FTO protein is associated with body mass index (BMI). It acts as an enzyme that induces epigenetic modifications in multiple genes. suggesting that the FTO protein is associated with several metabolic disorders, such as type 2 diabetes. Our study aimed to evaluate the protein levels of FTO in Syrian patients newly diagnosed with type 2 diabetes.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eThis case‒control study involved 80 participants selected from the National University Hospital in Damascus.it divided into two primary groups: 44 newly diagnosed type 2 diabetic patients and 36 nondiabetic participants, including 22 obese participants and 14 normal weight participants. Serum levels of FTO protein were measured by Sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA), fasting blood glucose (FBG), glycated hemoglobin (HbA1c), fasting insulin (FINS) and insulin resistance were assessed for each participant. The statistical analysis was performed using IBM SPSS statistics (version 27) software. The Mann‒Whitney test, the independent t test, ANOVA and the Kruskal‒Wallis test were used. Correlations were assessed via Pearson\u0026rsquo;s test and via Spearman\u0026rsquo;s test for the subgroups. A p value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eThe serum levels of FTO protein did not differ between type 2 diabetes and nondiabetic participants(p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), but they differ between the obese-nondiabetic group and the normal weight- nondiabetic group(p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Serum FTO levels were correlated with insulin(p\u0026thinsp;=\u0026thinsp;0.001) and insulin resistance(p\u0026thinsp;=\u0026thinsp;0.001) in the nondiabetic group, but were not correlated with newly diagnosed type 2 diabetes(p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eDiscussion:\u003c/h2\u003e \u003cp\u003eSerum levels of FTO appear to be more strongly associated with obesity than with diabetes.\u003c/p\u003e","manuscriptTitle":"Serum FTO Protein Levels in Newly Diagnosed Type 2 Diabetes Patients in Syria: A Case‒Control Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-02 10:26:14","doi":"10.21203/rs.3.rs-8321576/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision 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