Participants with the highest PDI score had significantly lower PTH (Ptrend = 0.02) just after adjusting for confounders, including age, sex, smoking, physical activity, marital status, income levels, BMI, total energy, diabetes, hypertension, and dyslipidemia (Ptrend = 0.03), and they also had significantly higher insulin serum levels (Ptrend = 0.03), which was also seen after the confounders were adjusted (Ptrend = 0.02). Here, INS is linked to metabolic syndrome.