Prevalence of Elevated Insulin Resistance Risk in a Large Office Worker Population: Sex-Stratified Analyses and Lifestyle Correlates

Background: Insulin resistance (IR) is a key pathophysiological mechanism linking obesity, type 2 diabetes, and cardiovascular disease. Office workers, due to prolonged sedentary behavior and suboptimal lifestyle patterns, may be particularly susceptible to IR. However, large-scale studies in this occupational group remain scarce. Objective: To evaluate the prevalence of elevated IR risk using non–insulin-based indices—TyG, METS-IR, and SPISE—and their associations with sociodemographic and lifestyle factors in a large sample of Spanish office workers. Methods: This cross-sectional study included 82,020 office workers from Spain (2021–2022). IR risk was assessed using the TyG index, METS-IR, and SPISE, all derived from fasting biochemical and anthropometric data. Sociodemographic and lifestyle variables were self-reported using validated questionnaires. Sex-stratified analyses and multivariate logistic regression models were performed. Results: Men showed significantly higher odds of elevated IR risk compared to women across all indices: TyG (OR = 2.48, 95% CI: 2.37–2.60), METS-IR (OR = 1.47, 95% CI: 1.38–1.57), and SPISE (OR = 1.88, 95% CI: 1.78–1.99). Smoking, physical inactivity, and low adherence to the Mediterranean diet were independently associated with elevated IR scores, regardless of sex or age. Conclusions: A substantial proportion of office workers exhibit elevated insulin resistance risk, particularly among men and those with unhealthy lifestyles. TyG, METS-IR, and SPISE are valuable, low-cost tools for early IR detection in occupational health settings. These findings support the implementation of preventive strategies targeting modifiable behaviors in sedentary working populations.