BACKGROUND Insulin resistance and hyperinsulinemia are involved in the etiology of metabolic syndrome (MetS) and its components. OBJECTIVE The current study assessed the association of dietary insulin load (DIL) and dietary insulin index (DII) with the odds of having MetS among a large population of Iranian adults. DESIGN This study was a cross-sectional analysis of the Shahedieh cohort study, which began in 2015-2016 and continues to the present day. PARTICIPANTS/SETTING A total of 5,954 Iranian adults, aged 35 to 70 years, were included in the current analysis. To collect dietary data, the validated block-format 120-item semiquantitative Food Frequency Questionnaire was used. MetS was defined using the criteria belonging to the Iranian-modified National Cholesterol Education Program for Adults. MAIN OUTCOME MEASURES Enzymatic colorimetric tests were used to measure fasting blood glucose, triglyceride, and high-density lipoprotein cholesterol concentrations; blood pressure and waist circumference were measured using the standard protocols. STATISTICAL ANALYSIS Binary logistic regression with adjusted models was used to examine the association of DIL and DII with MetS. RESULTS After taking potential confounders into account, moderate DIL was associated with increased odds of MetS in men, meaning that men in the third quartile of DIL had 61% greater odds for having MetS compared with those in the first quartile (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.02-2.54). Such a significant association was not seen for DII. In women, DIL was significantly associated with increased odds of developing MetS. After controlling for potential confounders, women in the top quartile of DIL had 77% greater odds for having MetS compared with women in the bottom quartile (OR: 1.77; 95% CI: 1.08-2.91). This significant positive association was also seen for DII, such that a higher score of DII was associated with 41% greater odds of MetS (OR: 1.41, 95% CI: 1.08-1.83). CONCLUSIONS Adherence to a diet with a high DIL and DII is associated with greater odds of having MetS in women. Also, moderate DIL was associated with increased odds of MetS in men.

中文翻译：

---

与代谢综合征相关的膳食胰岛素指数和膳食胰岛素负荷：Shahedieh 队列研究

背景胰岛素抵抗和高胰岛素血症涉及代谢综合征(MetS)及其成分的病因学。目的 目前的研究评估了膳食胰岛素负荷 (DIL) 和膳食胰岛素指数 (DII) 与大量伊朗成年人患 MetS 的几率之间的关联。设计 本研究是对 Shahedieh 队列研究的横断面分析，该研究于 2015-2016 年开始并持续至今。参与者/环境 本次分析共包括 5,954 名年龄在 35 至 70 岁之间的伊朗成年人。为了收集饮食数据，使用了经过验证的块格式 120 项半定量食物频率问卷。MetS 是使用属于伊朗修改的国家成人胆固醇教育计划的标准定义的。主要观察指标 酶促比色试验用于测量空腹血糖、甘油三酯和高密度脂蛋白胆固醇浓度；使用标准方案测量血压和腰围。统计分析 使用调整模型的二元逻辑回归来检查 DIL 和 DII 与 MetS 的关联。结果 考虑到潜在的混杂因素后，中度 DIL 与男性 MetS 的几率增加有关，这意味着 DIL 的第三四分位数的男性患 MetS 的几率比第一四分位数的男性高 61%（优势比 [OR] : 1.61, 95% 置信区间 [CI]: 1.02-2.54)。DII 没有看到如此显着的关联。在女性中，DIL 与发生 MetS 的几率增加显着相关。控制潜在的混杂因素后，DIL 最高四分位数的女性患 MetS 的几率比最低四分位数的女性高 77%（OR：1.77；95% CI：1.08-2.91）。DII 也观察到了这种显着的正相关，因此 DII 得分越高，MetS 的几率增加 41%（OR：1.41，95% CI：1.08-1.83）。结论 坚持高 DIL 和 DII 的饮食与女性患 MetS 的几率更大有关。此外，中度 DIL 与男性 MetS 几率增加有关。08-1.83)。结论 坚持高 DIL 和 DII 的饮食与女性患 MetS 的几率更大有关。此外，中度 DIL 与男性 MetS 几率增加有关。08-1.83)。结论 坚持高 DIL 和 DII 的饮食与女性患 MetS 的几率更大有关。此外，中度 DIL 与男性 MetS 几率增加有关。