Mitochondrial electron transport chain, ceramide, and coenzyme Q are linked in a pathway that drives insulin resistance in skeletal muscle.

Gene set enrichment revealed a highly significant general trend following the difference in insulin sensitivity (measured by the rate of glucose disappearance –Rd- using a stable isotope – [6,6- 2 H 2 ]glucose – during a hyperinsulinemic-euglycemic clamp; Perreault et al., 2018 ), where TCA cycle and respiratory electron transport and complex I biogenesis were enriched as follows: athletes > lean > obese > T2D ( Source data 10 ).

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