Weight, total protein (TP), and transferrin (TRF) demonstrated robust MetS-dependent differential responses (pinteraction<0.05), while skeletal muscle index (SMI), prealbumin (PA), and albumin (ALB) showed non-significant trends for interactions (0.05 < pinteraction<0.10), collectively indicating MetS attenuates therapeutic efficacy across nutritional and musculoskeletal metrics. Here, TTR is linked to metabolic syndrome.