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Background: Metabolic syndrome (MS) is known to increase the risk of various cardiometabolic diseases and insulinresistance (IR) has known to have central role in the development of MS. Many surrogate indices of IR havebeen proposed and the detection of MS might be a suitable model for assessing the accuracy of surrogate indices. The aims of our study are to invest the most appropriate index by assessment of the diagnostic capacity of IR amongeach surrogate index and identifying cut-off values for discriminating uncomplicated MS in Korean adults. Methods: A cross-sectional study was performed, assessing 294 Korean adults, 85 of whom were diagnosed withuncomplicated MS. The sensitivities and specificities of five surrogate IR indices were compared to discriminateMS from healthy subjects; these included fasting serum insulin, homeostasis model assessment–insulin resistanceindex, quantitative insulin sensitivity check index, McAuley index, and Disse index. Correlations between each indexvalue were assessed using Pearson’s and Spearman’s correlation methods. Results: The McAuley index showed the highest area under the curve (0.85), specificity (86.12%), accuracy(82.31%), positive predictive value (68.13%), and negative predictive value (88.67%) to distinguish MS, with a cut-offpoint of 5.3 defined. Correlation coefficients of the five indices showed that the McAuley index had the strongestcorrelation with IR. Conclusion: The McAuley index showed the best accuracy in the detection of MS as a surrogate marker of IR. Toestablish more effective and accurate standards of measuring IR, comprehensive and multi-scaled studies are required.

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