The other gap that is critical is the non-uniformity in the definition and application of MetS criteria, in which studies employed modified criteria, replaced BMI with waist circumference (Wulsin et al. 2015 [22]), or only analyzed insulin resistance but not the entire syndrome (Poon et al. (2020) [26]; Fowokan et al. (2017) [25]), restricting the comparability of results between populations. Here, INS is linked to metabolic syndrome.