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Endoplasmic reticulum stress activates intracellular inflammatory signaling pathways, leading to the activation of NF-B, which further increases the expression of cytokines and chemokines, promoting the recruitment of leukocytes and activation of inflammatory immune cells [32, 34]

When insulin resistance occurs, mitochondrial-related protein levels change, mitochondrial membrane potential decreases, calcium homeostasis is disrupted (29), and reactive oxygen species (ROS) production increases, leading to cell death

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The instrument demonstrated strong internal consistency (Cronbachs = 0.88) in a general-population sample and excellent 2-week testretest reliability ( r = 0.87), with evidence of good validity in both clinical and non-clinical samples [131, 132]

The parallel is striking and instructive