the goal of this observation study is to learn about association between intestinal endotoxemia and prediabetes lean patients with the aim of prevention of diabetes in those category of patients

Primary Objective : To determine the correlation between intestinal endotoxemia (measured by serum LBP) and basal beta-cell dysfunction (HOMA-B) in lean prediabetic patients with minimal insulin resistance (HOMA-IR <1.5).

Secondary Objectives:

1. Compare endotoxemia levels (LBP) between lean prediabetic (HOMA-IR <1.5) and healthy controls.
2. Evaluate LBP's association with fasting glucose and insulin in beta-cell dysfunction phenotype.

Hypothesis:

In lean prediabetes with beta-cell dysfunction (HOMA-IR <1.5), serum LBP levels correlate significantly with HOMA-B, indicating endotoxemia-driven beta-cell impairment.

Inclusion Criteria:

• Age: 18-65 years
• BMI: 18.5-24.9 kg/m²
• ADA prediabetes: FPG 100-125 mg/dL OR 2hPG 140-199 mg/dL OR HbA1c 5.7-6.4%
• HOMA-IR <1.5 (key inclusion criterion)

Exclusion Criteria:

• - HOMA-IR ≥1.5
• BMI ≥25 kg/m²
• Diabetes, acute inflammation, GI disorders (Table 1) Group II (Controls): Lean normoglycemic ; age and sex-matched healthy subjects

The patient population for the trial will be derived from Outpatient clinics, Sohag University Hospital 120 participants .

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