In vitro studies have shown that Porphyromonas gingivalis BEVs inhibit hepatic glycogen synthesis and enhance insulin resistance, possibly related to inhibition of the AKT/GSK-3β signaling pathway (Furusho et al., 2013; Fleetwood et al., 2017; Seyama et al., 2020; Villard et al., 2021; Kim et al., 2024). This evidence concerns the gene AKT1 and Insulin resistance.