Similarly, the indirect association between adiponectin and MetS-AHA/NHLBI was significantly different from zero after controlling for insulin (z-test = 2.225, SE = 0.009, P = 0.026), BMI (z-test = 2.633, SE = 0.011, P = 0.008), waist circumference (z-test = 2.441, SE = 0.011, P = 0.015) or HDL-cholesterol (z-test = 1.980, SE = 0.010, P = 0.048). Here, INS is linked to metabolic syndrome.