Study procedure and biomarker measurement
BLOOD, INSULIN RESISTANCE
The blood samples were collected from each patient after overnight 12 hours (h) fasting period, a drop of blood was used to determine the fasting blood glucose using the glucometer. Patients were allowed to have breakfast, then after 2 h, the glucometer was used to determine the 2 h post prandial glucose. All these samples were collected at the beginning of the study and after 3 months of receiving the medication of interest. Blood samples were centrifuged at 2000–3000 rpm for 20 min, separated, collected in tubes, and stored at – 80 °C until biochemical analysis was performed. Fasting glucose, and 2 h. Post prandial glucose were determined using glucometer (Rightest, Bionime Corporation, Taiwan). Enzyme-Linked ImuunoSorbent Assay (ELISA) kits (Sunred biological technology Co., Ltd., Shanghai) were used in duplicate to determine fasting insulin (kit catalogue number: 201-12-0011, sensitivity: 0.352 mU/l, and assay range: 0.4–100 mU/l), glycated hemoglobin (Turbidimetric kit catalogue number: HBT1-100-0100, sensitivity: 1.4%, and assay range: 1.4%–14%), interleukin-34 (IL-34) (kit catalogue number: 201-12-0044, sensitivity: 4.336 ng/ml, and assay range: 5–1500 ng/ml), extracellular domain of insulin regulated aminopeptidase (IRAPe) (kit catalogue number: 201–12-4150, sensitivity: 0.236 ng/ml, and assay range: 0.25–72 ng/ml), and natriuretic peptides (NT-proBNP) (kit catalogue number: 201-12-1240, sensitivity: 1.117 pg/ml, and assay range: 2–360 pg/ml). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was calculated from the equation: