Alpha1-antitrypsin (α1-AT), another candidate biomarker found in our studies with lower plasma levels in cases both at baseline and follow-up, is a serine proteinase inhibitor associated with type 2 diabetes [34–36] which amongst other effects inhibits the enzymatic activity of neutrophil elastase (NE) (which degrades adiponectin) and cathepsin G. This evidence concerns the gene CTSG and type 2 diabetes mellitus.