Capturing metabolic syndrome: new thresholds for insulin resistance and novel body composition indices
Authors' conclusion
IR indices mediated the effect of altered body composition (i.e., reduced appendicular muscularity and increased visceral adiposity) on MetS. Newly proposed diagnostic thresholds can aid in the identification of IR among patients at increased cardio-metabolic risk.
Study context
- Population
- Adults ≥18 years with BMI ≥25 kg/m², White European, without DM, not pregnant; 80.9% female; Metabolic syndrome (MetS) prevalence 40%665 assessed
- Participants
- 515 adults
- Exposure
- ISI-Matsuda vs HOMA-IR vs HOMA2-IR
- Outcome
- Novel IR cut-points for MetS presence (ROC analysis)
Methodological detailsROC curve analysis with 5-fold cross-validation, mediation analysis
- ROC curve analysis with 5-fold cross-validation
- Mediation analysis
Main finding
As reported in the abstract
| Group | Value | AUROC | P |
|---|---|---|---|
| ISI-Matsuda | <3.33 | 0.675 | p < 0.001 |
| HOMA-IR | > 2.93 | 0.663 | p < 0.001 |
| HOMA2-IR | > 1.67 | 0.651 | p < 0.001 |
Value
ISI-Matsuda<3.33
HOMA-IR> 2.93
HOMA2-IR> 1.67
AUROC
ISI-Matsuda0.675
HOMA-IR0.663
HOMA2-IR0.651
P
ISI-Matsudap < 0.001
HOMA-IRp < 0.001
HOMA2-IRp < 0.001
Observational data: associations, not effects.
Further findings
Concordance of IR definitions (Cohen's κ)
- IR definitions previously validated against the hyperinsulinemic-euglycemic clamp displayed the highest agreement
Body composition, IR and MetS (mediation analysis)
- ALST:VFA but not FM:FFM significantly predicted MetS status independent of age, mediated by ISI-Matsuda, HOMA-IR and HOMA2-IR
Original publication
Capturing metabolic syndrome: new thresholds for insulin resistance and novel body composition indices. Int J Obes (Lond). Published 3 January 2026. doi:10.
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