Publication Name	World Journal of Diabetes
Manuscript ID	119998
Country	China

Category	Endocrinology & Metabolism
Manuscript Type	Opinion Review
Article Title	Hidden metabolic crisis in lean youth: Waist-to-height ratio uncovers endoplasmic reticulum stress-driven insulin resistance in platelets
Manuscript Source	Invited Manuscript
All Author List	Zeng-Gao Han, Yang Yang, Peng-Yan Huang, Min Yang, Guo-Dong Zhang, Xu Yang, Chen-Yu Song, Jing-Shun Lu and Kai-Yang Wang
Funding Agency and Grant Number
Corresponding Author	Kai-Yang Wang, Assistant Professor, Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600 Yishan Road, Shanghai 200233, China. ortho_wang@163.com
Key Words	Insulin resistance; Waist-to-height ratio; Endoplasmic reticulum stress; Platelet; Body mass index; Adiposity; Metabolic syndrome; Adolescent
Core Tip	The waist-to-height ratio, with a threshold of > 0.5, offers a simple yet powerful anthropometric tool to unmask hidden insulin resistance and cardiometabolic risk in metabolically unhealthy normal-weight youth - a population routinely missed by body mass index-centric screening. This paradigm shift is grounded in mechanistic links among visceral adiposity, systemic inflammation, and endoplasmic reticulum stress, with emerging evidence positioning platelets as accessible biosensors of endoplasmic reticulum stress. Integrating waist-to-height ratio into routine youth health assessments enables early, precise intervention and holds potential to curb the lifelong burden of metabolic disease.
Citation	Han ZG, Yang Y, Huang PY, Yang M, Zhang GD, Yang X, Song CY, Lu JS, Wang KY. Hidden metabolic crisis in lean youth: Waist-to-height ratio uncovers endoplasmic reticulum stress-driven insulin resistance in platelets. World J Diabetes 2026; In press

Received	2026-02-12 00:51
Peer-Review Started	2026-02-12 23:58
First Decision by Editorial Office Director	2026-02-25 07:49
Return for Revision	2026-02-25 07:49
Revised	2026-03-08 16:58
Publication Fee Transferred
Second Decision by Editor	2026-05-06 03:20
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-05-06 06:41
Articles in Press	2026-05-06 06:41
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9358 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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