INS and Insulin resistance: The strong association between PBP4 levels and insulin resistance observed in our study is in line with recent findings that have identified PBP4 as a potential biomarker for evaluating insulin resistance and β-cell dysfunction.[14] PBP4, also known as apolipoprotein M, has been shown to strengthen insulin signaling, potentially contributing to the improvement of insulin resistance.[15] As an apolipoprotein, PBP4 may enhance insulin sensitivity by facilitating blood lipid metabolism and expediting glucose uptake, thereby delaying to elevated neonatal birth weight.[16]