Acet A., Pasali Kilit T., Erarslan S., Yalçın C., Özlü C., Özdemir Ç.
PEERJ, cilt.14, ss.1-18, 2026 (SCI-Expanded, Scopus)
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Yayın Türü:
Makale / Tam Makale
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Cilt numarası:
14
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Basım Tarihi:
2026
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Doi Numarası:
10.7717/peerj.21769
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Dergi Adı:
PEERJ
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Derginin Tarandığı İndeksler:
Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Scopus, Science Citation Index Expanded (SCI-EXPANDED), BIOSIS, EMBASE, CAB Abstracts, MEDLINE, Directory of Open Access Journals
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Sayfa Sayıları:
ss.1-18
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Açık Arşiv Koleksiyonu:
AVESİS Açık Erişim Koleksiyonu
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Kütahya Sağlık Bilimleri Üniversitesi Adresli:
Evet
Özet
Background
Insulin resistance (IR) is a key mechanism underlying type 2 diabetes mellitus and cardiometabolic disease. Although obesity-related inflammation is a major contributor to IR, increasing evidence indicates that IR may also develop in non-obese individuals. However, readily available inflammatory markers applicable to this population remain limited. We evaluated the association between inflammatory markers and insulin resistance in non-obese adults and assessed their predictive performance across body mass index (BMI) strata.
Methods
This retrospective cross-sectional study included 149 non-obese adults (BMI < 30 kg/m
2
) evaluated in an internal medicine outpatient clinic between January and December 2025. Insulin resistance was defined as a homeostasis model assessment of insulin resistance (HOMA-IR) ≥ 2.5. Inflammatory markers and composite indices, including the C-reactive protein to high-density lipoprotein cholesterol (CRP/HDL) ratio, were calculated. Multivariable logistic regression, BMI-stratified analyses, and receiver operating characteristic (ROC) curve analyses were performed.
Results
Insulin resistance was identified in 54 participants (36.2%). Individuals with IR had higher white blood cell (WBC) counts, CRP levels, and CRP/HDL ratios (all
p
< 0.05). In multivariable analysis, WBC count was independently associated with IR (OR = 1.407, 95% CI [1.090–1.815];
p
= 0.009). BMI-stratified analyses showed that WBC count independently predicted IR in normal-weight individuals (OR = 1.789, 95% CI [1.218–2.627];
p
= 0.003), whereas in overweight participants (BMI 25–30 kg/m
2
), the CRP/HDL ratio was independently associated with IR (OR = 7.793, 95% CI [1.056–57.499];
p
= 0.044). ROC analyses demonstrated higher discriminative performance of WBC count in normal-weight individuals (AUC = 0.720) and greater predictive ability of the CRP/HDL ratio in overweight individuals (AUC = 0.695).
Conclusions
Low-grade systemic inflammation is independently associated with insulin resistance in non-obese adults, with distinct inflammatory predictors across BMI categories. WBC count may reflect early immune activation in normal-weight individuals, whereas the CRP/HDL ratio appears more informative among overweight subjects.