Biochemical Measurements in Fasting Participants

The method used for the measurement of biochemical parameters in this survey has been published previously [17 (link),20 (link)]. For brevity, study participants fasted for at least 10 h prior to the collection of fasting blood samples. The Siemens Dimension RXL chemistry analyser (Diamond Diagnostics, Holliston, MA, USA) was used to measure the blood glucose and lipids profile. The participants were measured for HbA1c using a Variant device (Bio-Rad Laboratories, Hercules, GA, USA). The Access Ultrasensitive Insulin Assay (Beckman Coulter, Brea, CA, USA) was used in measuring insulin. Insulin resistance was calculated using the HOMA-IR formula: FBG (mmol/L) × fasting insulin (mU/L)/22.5 [23 (link)]. Hs-CRP concentrations were determined using ELISA (Hycult Biotech, Cat. no. HK369, Uden, The Netherlands), while ALT values in blood were analysed using the Dimension EXL Chemistry Analyser (Berlin, Germany) following manufacturer’s instructions. All blood analyses were conducted at the Dasman Diabetes Institute clinical laboratories in Kuwait.