In the fully adjusted models, an increase by 1 SD in PRAL and NEAP scores was associated with 13% (HR per SD: 1.13, 95% CI: 1.06–1.20) and 10% (HR per SD: 1.10, 95% CI: 1.05–1.16) increases in insulin resistance risk, respectively. Here, PRAL is linked to Insulin resistance.