Short title: Insulin Resistance and Metabolic Syndrome

OBJECTIVE- Metabolic syndrome (MetS) increases risk for type 2 DM and CVD and may be associated with insulin resistance (IR). RESEARCH DESIGN AND METHODS- We tested the hypothesis that MetS confers risk with or without concomitant IR among 2803 Framingham Offspring Study subjects followed up to 11 years for new DM (135 cases) or CVD (240). We classified subjects by presence of MetS (using ATP3, IDF, or EGIR criteria) and IR (HOMA-IR ≥75%ile) and used separate risk factor-adjusted proportional hazards models to estimate relative risks (RR) for DM or CVD using as referents those without IR, MetS, o