Elevated fasting insulin predicts the future incidence of metabolic syndrome: a 5-year follow-up study. July 16, 2018

Fasting insulin to predict metabolic syndrome?

Metabolic syndrome is a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels — that occur together, increasing your risk of heart disease, stroke and diabetes.
https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916

Now, if metabolic syndrome is elevated level of sugar then this lead to elevated level of insulin in blood, right? It is all the time so confusing, what is tail and where is the head? If I take this reading what do I expect?
How fasting insulin was tested?

Laboratory examinations were obtained after an overnight fast. The fasting plasma glucose, total cholesterol (TC), triglyceride(TG), low-density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) concentrations were measured using Bayer Reagent Packs on an automated chemistry analyzer (Advia 1650 Autoanalyzer; Bayer Diagnostics, Leverkusen, Germany)

OK, all tests are done according to the participant's blood. Still, where is the test how insulin was tested? All the article is about insulin level, high level of insulin , still:

Although the euglycemic insulin clamp test is currently the best and most accurate technique for assessing insulin sensitivity, the fasting insulin level was used as the marker for insulin resistance in this current study. The reason we didn't use the euglycemic insulin clamp technique is that it is almost impossible to perform this test in all the participants in this kind of large study population.

I tried to go over and over and I did not find no one test how fasting insulin was taken? Yes, the fasting blood sugar was taken. But the blood sugar and blood insulin are far away to be the same. To count high level of insulin there were formulas used. The same as it is used to count dose of insulin to inject. weight of the body : 4 = dose of insulin.  Simple.  So, because of every one of us has body weight, we all have to take insulin in the same dose, regardless of level of sugar in blood. This is why MD usually prefer to Rx Metformin. It is easy: 500 mg, 1000mg. 1500 mg. or 2000 mg. What about dose of insulin? It is very simple, formula does not work.
      Now we take
There is question, where insulin level? What is IR?

IR is insulin resistance and  %β is the β-cell function. Insulin is given in mU/L. Glucose and insulin are both during fasting.^[2]
This model correlated well with estimates using the euglycemic clamp method (r = 0.88)

 Formula ia very simple to be used if .... if we do know:

IR=?
HOMA=?
Insulin = ?
 IR = HOMA - Glucose * Insulin
                                         22.5
Glucose in Molar Units mmol/L

What about insulin? Inwhat insulin was measured?
HOMA, in what HOMA measured?
Well, I can go over and over the same questions, but there is only one answer: no one test taken to find out fasting level of INSULIN. Sugar, yes, this can be tested. INSULIn? Never.

So, what study studied? How much they will get in $$$$$$$ for these useless study.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275515/

via Ravenvoron