For instance, Méndez-Sánchez et al reported higher gallstone prevalence among individuals with IR quantified by Homeostatic Model Assessment of Insulin Resistance, suggesting a metabolic pathway to lithogenesis.[16] Our analysis extends this literature by demonstrating, in U.S. adults, that an IR surrogate based on triglycerides and glucose is positively related to gallstones and by characterizing a threshold effect not previously delineated. This evidence concerns the gene INS and gallstones.