Interestingly, whereas patients with MetS, with or without COPD, showed, as expected, a higher BMI and waist circumference, more elevated systolic and diastolic blood pressure values, higher serum glucose, insulin and triglyceride levels, lower HDL and a higher HOMA Index score as compared with COPD patients, those with both MetS and COPD had significantly higher serum levels of C-peptide than those in patients with either disease (Table 1). Here, INS is linked to chronic obstructive pulmonary disease.