2.1. Health Workers Cohort Study (HWCS)

This is a prospective open-label cohort study with follow-up investigations averaging six years and including participants enrolled between 2004 and 2018. The design and details of the study have been published previously [30]. In summary, the study aimed to analyze the influence of genetic and lifestyle factors on the occurrence of diverse chronic diseases. The blood samples and data were collected from health workers in various professions and their relatives from standard care clinics in Cuernavaca, Morelos. For this analysis, 602 subjects aged ≥18 with blood samples who had participated in the third wave between 2016 and 2018 were selected. The protocol was approved by IMSS (No. 12CEI 09 006 14, 17 May 2016) and the National Institute of Genomic Medicine (346–05/2018/I, 5 August 2018), following the Declaration of Helsinki (13/LO/0078). All participants provided written informed consent. Age was categorized as <45 and ≥45 years old because, based on previous studies, there are endocrine changes affecting metabolic traits in women and men around 45 years [31,32,33].