We found that the highest baseline SMI tertile was significantly associated with a decreased adjusted HR (AHR) for incident metabolic syndrome (0.60, 95% CI 0.54–0.68, P < 0.001) compared with the lowest tertile, after adjusting for age, sex, BMI, family history of diabetes, smoking status, regular exercise, eGFR, and CRP, (Model 4, Table 2). The gene discussed is CRP; the disease is diabetes mellitus.