# METS-IR (Bello-Chavolla 2018) METS-IR Status: LIVE Price: $0.005 USDC `GET /api/calc/mets_ir` HTML: https://magentlab.com/docs/mets-ir Markdown: https://magentlab.com/docs/mets-ir.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Bello-Chavolla 2018 METS-IR score from fasting glucose, triglycerides, caller-supplied BMI, and HDL as a marker of insulin sensitivity associated with visceral adiposity and incident type 2 diabetes. ## When to use When an agent needs published Bello-Chavolla 2018 METS-IR arithmetic and must not invent HOMA-IR, HOMA2, or a diabetes diagnosis. ## When not to use - Not a medical device. Not a diabetes diagnosis and not a treatment threshold. - Bello-Chavolla 2018 METS-IR only. Not HOMA-IR, not HOMA2, and not an insulin-resistance cutoff beyond the published derivation highest T2D-risk quartile (mets_ir > 50.39). - BMI is caller-supplied. magent does not compute BMI from height and weight in this tool. - Glucose, triglycerides, and HDL must each be exactly one of the mg/dL or mmol/L keys, not mixed within an analyte. ## Formula ``` mets_ir = ln(2 * glucose_mg_dl + triglycerides_mg_dl) * bmi_kg_m2 / ln(hdl_mg_dl) ``` ## Citation [METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes](https://doi.org/10.1530/eje-17-0883) Bello-Chavolla OY, Almeda-Valdes P, Gomez-Velasco D, Viveros-Ruiz T, Cruz-Bautista I, Romo-Romo A, Sánchez-Lázaro D, Meza-Oviedo D, Vargas-Vázquez A, Campos OA, Sevilla-González MDR, Martagón AJ, Hernández LM, Mehta R, Caballeros-Barragán CR, Aguilar-Salinas CA Eur J Endocrinol. 2018;178(5):533-544 DOI: [10.1530/eje-17-0883](https://doi.org/10.1530/eje-17-0883) ## Worked example ### Glucose 90 mg/dL, triglycerides 100 mg/dL, BMI 25, HDL 50 mg/dL Given: `bmi_kg_m2=25, glucose_mg_dl=90, hdl_mg_dl=50, triglycerides_mg_dl=100` 1. ln(2 * 90 + 100) = ln(280) ≈ 5.634789603 2. ln(50) ≈ 3.912023005 3. mets_ir = 5.634789603 * 25 / 3.912023005 = 36.01 4. 36.01 is not > 50.39 → highest_quartile_t2d false ## Also searched as - METS-IR - metabolic score for insulin resistance - Bello-Chavolla METS-IR - insulin sensitivity METS-IR - visceral adiposity METS-IR - incident type 2 diabetes METS-IR - METS IR score ## Parameters - `glucose_mg_dl` (number, optional): Fasting plasma glucose in mg/dL (50-1000). Provide this or glucose_mmol_l, not both. - `glucose_mmol_l` (number, optional): Fasting plasma glucose in mmol/L (2.8-55.5). Converted as mg/dL = mmol/L * 18. Provide this or glucose_mg_dl, not both. - `triglycerides_mg_dl` (number, optional): Triglycerides in mg/dL (10-2000). Provide this or triglycerides_mmol_l, not both. - `triglycerides_mmol_l` (number, optional): Triglycerides in mmol/L (0.11-22.6). Converted as mg/dL = mmol/L * 88.57. Provide this or triglycerides_mg_dl, not both. - `hdl_mg_dl` (number, optional): HDL cholesterol in mg/dL (5-150). Provide this or hdl_mmol_l, not both. Used in the natural-log term. - `hdl_mmol_l` (number, optional): HDL cholesterol in mmol/L (0.1-3.9). Converted as mg/dL = mmol/L * 38.67. Provide this or hdl_mg_dl, not both. - `bmi_kg_m2` (number, required): Body-mass index in kg/m^2 (10-80). Caller-supplied; magent does not compute BMI. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/mets_ir` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "bmi_kg_m2": "25", "glucose_mg_dl": "90", "hdl_mg_dl": "50", "triglycerides_mg_dl": "100" }, { "bmi_kg_m2": "25", "glucose_mg_dl": "90", "hdl_mg_dl": "50", "triglycerides_mg_dl": "100" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/mets-ir Example 200: ```json { "count": 2, "path": "/api/calc/mets_ir", "items": [ { "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Bello-Chavolla OY, Almeda-Valdes P, Gomez-Velasco D, Viveros-Ruiz T, Cruz-Bautista I, Romo-Romo A, Sánchez-Lázaro D, Meza-Oviedo D, Vargas-Vázquez A, Campos OA, Sevilla-González MDR, Martagón AJ, Hernández LM, Mehta R, Caballeros-Barragán CR, Aguilar-Salinas CA", "doi": "10.1530/eje-17-0883", "id": "bello-chavolla-2018", "pmid": "29535168", "source": "Eur J Endocrinol. 2018;178(5):533-544", "title": "METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes" }, "formula": "mets_ir", "formula_expression": "mets_ir = ln(2 * glucose_mg_dl + triglycerides_mg_dl) * bmi_kg_m2 / ln(hdl_mg_dl)", "bmi_kg_m2": 25.0, "glucose_mg_dl": 90.0, "hdl_mg_dl": 50.0, "triglycerides_mg_dl": 100.0, "highest_quartile_t2d": false, "mets_ir": 36.01 }, { "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Bello-Chavolla OY, Almeda-Valdes P, Gomez-Velasco D, Viveros-Ruiz T, Cruz-Bautista I, Romo-Romo A, Sánchez-Lázaro D, Meza-Oviedo D, Vargas-Vázquez A, Campos OA, Sevilla-González MDR, Martagón AJ, Hernández LM, Mehta R, Caballeros-Barragán CR, Aguilar-Salinas CA", "doi": "10.1530/eje-17-0883", "id": "bello-chavolla-2018", "pmid": "29535168", "source": "Eur J Endocrinol. 2018;178(5):533-544", "title": "METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes" }, "formula": "mets_ir", "formula_expression": "mets_ir = ln(2 * glucose_mg_dl + triglycerides_mg_dl) * bmi_kg_m2 / ln(hdl_mg_dl)", "bmi_kg_m2": 25.0, "glucose_mg_dl": 90.0, "hdl_mg_dl": 50.0, "triglycerides_mg_dl": 100.0, "highest_quartile_t2d": false, "mets_ir": 36.01 } ] } ``` ## Response fields - `formula` (string): mets_ir - `formula_expression` (string): Exact Bello-Chavolla 2018 expression (natural log; lipids in mg/dL) - `glucose_mg_dl` (number): Glucose used in mg/dL (after mmol/L conversion when supplied) - `triglycerides_mg_dl` (number): Triglycerides used in mg/dL (after mmol/L conversion when supplied) - `hdl_mg_dl` (number): HDL cholesterol used in mg/dL (after mmol/L conversion when supplied) - `bmi_kg_m2` (number): Caller-supplied BMI in kg/m^2 - `mets_ir` (number): Bello-Chavolla 2018 METS-IR, 2 decimals - `highest_quartile_t2d` (boolean): True iff mets_ir > 50.39 (derivation highest T2D-risk quartile). Equality is not highest. Not a diagnosis. - `citation` (object): Bello-Chavolla Eur J Endocrinol 2018 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Bello-Chavolla OY, Almeda-Valdes P, Gomez-Velasco D, Viveros-Ruiz T, Cruz-Bautista I, Romo-Romo A, Sánchez-Lázaro D, Meza-Oviedo D, Vargas-Vázquez A, Campos OA, Sevilla-González MDR, Martagón AJ, Hernández LM, Mehta R, Caballeros-Barragán CR, Aguilar-Salinas CA", "doi": "10.1530/eje-17-0883", "id": "bello-chavolla-2018", "pmid": "29535168", "source": "Eur J Endocrinol. 2018;178(5):533-544", "title": "METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes" }, "formula": "mets_ir", "formula_expression": "mets_ir = ln(2 * glucose_mg_dl + triglycerides_mg_dl) * bmi_kg_m2 / ln(hdl_mg_dl)", "bmi_kg_m2": 25.0, "glucose_mg_dl": 90.0, "hdl_mg_dl": 50.0, "triglycerides_mg_dl": 100.0, "highest_quartile_t2d": false, "mets_ir": 36.01 } ``` ## Errors - HTTP 400 `invalid_glucose`: glucose_mg_dl (50-1000) or glucose_mmol_l (2.8-55.5) is required Returned before settlement; you are not charged. - HTTP 400 `invalid_hdl`: hdl_mg_dl must be a number from 5 to 150, or hdl_mmol_l from 0.1 to 3.9, not both. Returned before settlement; you are not charged. - HTTP 400 `invalid_bmi_kg_m2`: bmi_kg_m2 must be a number from 10 to 80. Returned before settlement; you are not charged. - HTTP 400 `invalid_mets_ir_triglyceride`: triglycerides_mg_dl must be 10-2000, or triglycerides_mmol_l 0.11-22.6, not both. Do not use the Friedewald 400 mg/dL cap. Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [HOMA-IR](https://magentlab.com/docs/homa-ir) — Compute the Matthews 1985 HOMA-IR approximation from fasting plasma glucose and insulin. ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.