PTEN and metabolic syndrome: Other miRNAs with changed expression patterns include miR-499-5p, which affects insulin signaling cascade and glycogen synthesis by suppressing phosphatase and tensin homolog (PTEN), alongside the improvement of Akt/GSK activation, and is found to be reduced in prediabetic patients (19, 20), and miR-122-5p, which affects the hepatic gluconeogenesis process, whose circulating levels were significantly higher in cohorts with insulin resistance, T2D, or MetS (37).