Clinical Medicine & Physiology
METS-IR Calculator: Bello-Chavolla Non-Insulin Metabolic Score for Insulin Resistance
Quantify peripheral insulin sensitivity without fasting serum insulin assays using Omar Yaxmehen Bello-Chavolla et al.’s (2018) clamp-validated METS-IR = (LN(2 * FPG_mg_dL + TG_mg_dL) * BMI) / LN(HDL_mg_dL).
Estimate hyperinsulinemic-euglycemic clamp insulin resistance from routine Fasting Glucose, Lipids, and BMI!
Because fasting serum insulin immunoassays are expensive, poorly standardized across hospital platforms, and distorted in exogenous insulin or beta-cell decline, Omar Yaxmehen Bello-Chavolla et al. (2018, Eur. J. Endocrinol.) derived and validated METS-IR directly against gold-standard hyperinsulinemic-euglycemic clamp M-values, demonstrating superior diagnostic AUC over TG/HDL ratio and TyG-BMI!
Expressed in conventional mg/dL lab units and adult BMI (kg/m^2), METS-IR = (LN(2 * FPG_mg_dL + TG_mg_dL) * BMI) / LN(HDL_mg_dL)! In cohort validation against clamp-defined insulin resistance and incident Type 2 Diabetes / visceral adiposity, Bello-Chavolla established METS-IR > 50.0 (specifically > 50.39) as the high-specificity cutoff for metabolic insulin resistance!
| Clinical Profile (FPG, TG, HDL in mg/dL; BMI in kg/m^2) | Evaluated METS-IR | Metabolic Interpretation |
|---|---|---|
| Insulin-Sensitive Adult (FPG=88, TG=95, BMI=22.5, HDL=58) | 31.04 | Normal peripheral insulin sensitivity |
| Borderline Overweight (FPG=102, TG=155, BMI=28.0, HDL=44) | 43.53 | Intermediate cardiometabolic risk |
| Metabolic Syndrome (FPG=108, TG=184, BMI=31.0, HDL=40) | 50.35 | Elevated insulin resistance (> 50.0 threshold) |
Bello-Chavolla (2018) METS-IR Non-Insulin Insulin Resistance Score
Evaluates (LN(2 * FPG + TG) * BMI) / LN(HDL) across Fasting Plasma Glucose B2 (mg/dL), Fasting Triglycerides B3 (mg/dL), BMI B4 (kg/m^2), and HDL-Cholesterol B5 (> 1 mg/dL).
=IF(OR(B2 < 40, B2 > 600, B3 < 20, B3 > 2000, B4 < 12, B4 > 80, B5 <= 5, B5 > 150), "Invalid Fasting Glucose, TG, BMI, or HDL-C Inputs", ROUND((LN(2 * B2 + B3) * B4) / LN(B5), 2))METS-IR Cardiometabolic Risk Stratification (> 50.0 Cutoff)
Flags METS-IR > 50.0 for elevated insulin resistance and incident Type 2 Diabetes risk.
=IF(OR(B2 < 40, B2 > 600, B3 < 20, B3 > 2000, B4 < 12, B4 > 80, B5 <= 5, B5 > 150), "Invalid Fasting Glucose, TG, BMI, or HDL-C Inputs", IF((LN(2 * B2 + B3) * B4) / LN(B5) > 50, "METS-IR > 50.0: Elevated Insulin Resistance & T2DM Risk", "METS-IR <= 50.0: Below High-Risk Clamp Resistance Cutoff"))Try the example
Use the original values or change them to test your understanding.