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The nomogram based on the model presented good discrimination (AUC 0.76), good calibration (Hosmer-Lemeshow Test, P0.05) and a net benefit in the range of probabilities between 10% and 70%. Metabolic syndrome is highly prevalent in patients at risk of prostate cancer and is particularly associated with high-grade prostate cancer. Our nomogram offers the possibility to include metabolic status in the assessment of patients at risk of prostate cancer to identify men who may have a high-grade form of the disease. External validation is