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Biomarkers

METS-IR

A non-insulin index of insulin sensitivity

METS-IR — an index of insulin sensitivity from blood tests

METS-IR (Metabolic Score for Insulin Resistance) is a surrogate index of insulin resistance, proposed by Bello-Chavolla et al. in 2018.

It estimates insulin sensitivity from routine markers, without a direct insulin assay, and was validated against the "gold standard" — the euglycemic clamp.

Reference ranges

METS-IR is interpreted relative to the population — the higher the value, the lower the insulin sensitivity:

Lowerbetter insulin sensitivity
Higher (roughly from ~50)a sign of insulin resistance
Important: There is no single universal threshold; higher METS-IR values are associated with a rising risk of diabetes, metabolic syndrome and cardiovascular events.

What an elevated level means

A high METS-IR indicates insulin resistance and is associated with an increased risk of type 2 diabetes, metabolic syndrome and cardiovascular disease (data from large cohorts, including NHANES).

What a low level means

A low METS-IR means good insulin sensitivity.

How the test is done

The formula: METS-IR = ln(2 × glucose + TG) × BMI / ln(HDL) (glucose, TG and HDL in mg/dL). You need glucose, triglycerides, HDL and BMI. An insulin test is not required.

Calculate using this marker

Calculators where METS-IR (Metabolic Score for Insulin Resistance) is used directly:

Frequently asked questions

How does METS-IR differ from HOMA-IR?

HOMA-IR requires an insulin test, whereas METS-IR is calculated without one — from glucose, triglycerides, HDL and BMI. That makes METS-IR convenient for screening when insulin has not been measured.

What METS-IR is considered high?

There is no single threshold — the index is compared against the population; values roughly from 50 upward are linked to insulin resistance. What matters is not one number but the combination with blood sugar, lipids and waist circumference.

Related terms

Sources

  1. Bello-Chavolla OY et al. METS-IR, a novel score to evaluate insulin sensitivity. Eur J Endocrinol, 2018
  2. MDCalc — Metabolic Score for Insulin Resistance (METS-IR)
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This content is educational and does not replace consultation with a physician. Reference ranges may vary depending on the laboratory and method — rely on the ranges stated on your own test report.
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