INS and metabolic syndrome: After adjustment of confounders (age, sex, income level, smoking history, alcohol consumption, regular physical activity, hypertension, dyslipidemia, fasting glucose, duration of DM, use of insulin, and number of oral antidiabetic medications), people who were underweight showed a 2.4-fold increased risk of SCD during follow-up (adjusted-HR = 2.40; 95% CI = 2.26–2.56; p < 0.001; Table 2).