After adjustment for age, gender, current smoking, alcohol consumption and physical activity, increased serum Nrg4 was significantly associated with reduced risk of raised fasting glucose and prevalence of MetS (OR: 0.809; 95 % CI, 0.657–0.997 and 0.769; 0.621–0.952, respectively); however, serum Nrg4 was not significantly associated with risks of raised blood pressure (P = 0.057), raised triglycerides (P = 0.899) or reduced HDL-cholesterol (P = 0.991). Here, NRG4 is linked to metabolic syndrome.