INS and Insulin resistance: The NMS2 group, composed of individuals with one or two metabolic alterations, also showed significant differences in several of these parameters compared to the NMS0 group, particularly in insulin levels, triglycerides, and waist circumference, suggesting that these alterations may be early indicators of insulin resistance and cardiovascular risk (Guerrero-Romero et al., 2016; Wall-Medrano et al., 2016).