A pilot study in menopausal women with prediabetes: refining the blood exerkine irisin assay in relationship with the calcium-phosphorus metabolism

Objective. In this pilot study, we aimed to analyze the blood irisin levels in relation to glucose and mineral metabolism assays in menopausal women with non-diabetic altered glucose regulation: impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Methods. This was a prospective, transversal, non-interventional, bi-centric (bi-country) study, between December 2024 and October 2025. Results. The patients (N=47) with IGT (N=21) or IFG (N=26) had a similar age (63±9.24 versus 63.46±8.16years, p=0.856), menopause duration (14.05±9.37 versus 16.76±8.07years, p=0.297), and body mass index with mean values within the obesity range (34.84±5.07 versus 31.34±6.46kg/sqm, p=0.765). Average 25-hydroxyvitamin D showed an insufficiency (28.62±8.09 versus 28.06± 6.99ng/mL). The IGT versus IFG group were found with statistically significantly higher 1-hour glycaemia in the oral glucose tolerance test (207.04±34.72 versus 179.40±33.91mg/dL, p=0.009), 2-hour insulin (101.44±67.26 versus 48.97±34.35 µUI/mL, p=001), fasting insulin (13.00±7.38 versus 8.36±3.96µUI/mL, p=0.008); HOMA-IR (3.53±2.32 versus 2.27±1.17; p=0.21) with mean levels sustaining insulin resistance. Conclusion. Circulating irisin was marginally elevated in the IGT versus the IFG group and positively correlated with body mass index in both. We found no correlation with the glucose profile, but with selective mineral metabolism assays. This pilot study requires an expansion of the sample size to pinpoint the potential practical utility of irisin as a biomarker.