First of all, in cohort 1, because of the complexity of HEC operation technology, the sample size for repeated measurement is limited; in cohort 2, the sample size for HEC assessment of insulin sensitivity before and after metabolic surgery is not easy to obtain, so it cannot be included in the same subjects as cohort 1, and the subjects from the IGR/T2DM group in cohort 1 are different from those in cohort 2. This evidence concerns the gene INS and type 2 diabetes mellitus.