INS and metabolic syndrome: In contrast, in the cohort study of Grøntved et al. [42], the outcome was calculated as a continuous MetS z-score to preserve statistical power and because the number of incident cases of MetS according to the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) definitions with the additional inclusion of fasting insulin was calculated as a continuous MetS z-score.