Also, another study carried with US NHANES 2001–2010, found an inverse association between urinary enterolactone levels and obesity, waist circumference, serum triacylglycerols (TAG) levels, fasting glucose levels, fasting insulin levels and metabolic syndrome in adult males, and a direct association with high-density lipoprotein HDL-cholesterol levels [64]. Here, INS is linked to metabolic syndrome.