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The criteria for IR is: HOMA-IR = fasting blood glucose (mmol/L) * fasting insulin (uU/mL)/22.5

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Hormonal Changes Fluctuations in hormones can trigger a condition called melasma, which causes brown or gray-brown patches to appear on the face, typically on the cheeks, forehead, and upper lip

Furthermore, gliadin-tissue transglutaminase complexes formed by protein cross- linkages generate an autoantibody response (predominantly immunoglobulin A [IgA] type) that can exacerbate the inflammatory process