Subjects of this retrospective cohort study were selected from TCGS participants [33]. TCGS is an ongoing genetic study that is a part of the Tehran Lipid and Glucose Study (TLGS). This cohort study estimates the prevalence of non-communicable disease risk factors in a sample of Tehran’s (capital of Iran) 13th district residents [34]. The first survey of the TLGS was initiated from 1999 to 2001 on 15,005 individuals aged 3 years, and subjects were genotyped and followed up to identify recently developed diseases every 3 years. In the current study, we excluded individuals with prevalent MetS at baseline. A total of 5666 adults 19–88 aged years who had complete demographic, anthropometric, biochemical, and genotype baseline data were included in the statistical analyses. All subjects’ written consent was obtained, and the Research Institute for Endocrine Sciences (affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran) approved this study.

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