Our findings provide strong and replicated evidence for chronic low-level inflammation (elevated CRP and cystatin C levels, and platelet, leucocyte and neutrophil counts), insulin resistance (elevated triglycerides-to-HDL-C ratio, ALT, ALP, GGT and HbA1c) and/or liver disease (elevated ALT, ALP and GGT, and low urea levels) in ME/CFS (Fig. 2A). This evidence concerns the gene CST3 and Insulin resistance.