Association of Inflammatory Biomarkers With Insulin Resistance Across Different Glycemic States

Abstract

Low-grade systemic inflammation has been implicated in the development of insulin resistance, but the strength of this relationship may differ across stages of glucose dysregulation. This study evaluated the association between inflammatory biomarkers and insulin resistance among adults with normal glucose regulation, prediabetes, and type 2 diabetes. A cross-sectional study included 180 adults divided into three glycemic groups. Serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured, while insulin resistance was estimated using HOMA-IR. Participants with prediabetes and type 2 diabetes had progressively higher inflammatory biomarker concentrations and HOMA-IR compared with individuals with normal glucose regulation. Hs-CRP and IL-6 demonstrated significant positive correlations with HOMA-IR across all groups. After adjustment for age, sex, BMI, and physical activity, hs-CRP and IL-6 remained independently associated with insulin resistance. The associations were strongest among participants with type 2 diabetes. These findings suggest that low-grade inflammation is associated with insulin resistance across different stages of glycemic dysregulation.