Anthropometric Cut-Off Values for Detecting the Presence of Metabolic Syndrome and Its Multiple Components among Adults in Vietnam: The Role of Novel Indices

Utility of Anthropometric Indexes for Detecting Metabolic Syndrome in Resource-Limited Regions of Northwestern China: Cross-Sectional Study

Background

Anthropometric indexes offer a practical approach to identifying metabolic syndrome (MetS) and its components. However, there is a scarcity of research on anthropometric indexes tailored to predict MetS in populations from resource-limited regions.

Objective

This study aimed to examine the association between 8 easy-to-collect anthropometric indexes and MetS, and determine the most appropriate indexes to identify the presence of MetS for adults in resource-limited areas.

Methods

A total of 10,520 participants aged 18-85 years from Ningxia Hui Autonomous Region, China, were included in this cross-sectional study. Participants were recruited through a stratified sampling approach from January 1, 2020, to December 31, 2021. MetS was defined using the International Diabetes Federation (IDF) criteria. Eight anthropometric indexes were examined, including BMI, waist-to-height ratio (WHtR), weight-adjusted waist index (WWI), conicity index, a body shape index (ABSI), lipid accumulation products (LAP), visceral obesity index (VAI), and the triglyceride-glucose (TyG) index. Logistic regression analysis and restricted cubic splines (RCSs) were applied to identify the association between the anthropometric indexes. The receiver operating characteristic curve and the area under the curve (AUC) were analyzed to identify and compare the discriminative power of anthropometric indexes in identifying MetS. The Youden index was used to determine a range of optimal diagnostic thresholds. Logistic regression analysis was applied to identify the association between the anthropometric indexes.

Results

A total of 3324 (31.60%) participants were diagnosed with MetS. After adjusting for age, ethnicity, current residence, education level, habitual alcohol consumption, and tobacco use, all the 8 indexes were positively correlated with the risks of MetS (P<.05). LAP presented the highest adjusted odds ratios (adjOR 35.69, 95% CI 34.59-36.80), followed by WHtR (adjOR 29.27, 95% CI 28.00-30.55), conicity index (adjOR 11.58, 95% CI 10.95-12.22), TyG index (adjOR 5.53, 95% CI 5.07-6.04), BMI (adjOR 3.88, 95% CI 3.71-4.05), WWI (adjOR 3.23, 95% CI 3.02-3.46), VAI (adjOR 2.11, 95% CI 2.02-2.20), and ABSI (adjOR 1.71, 95% CI 1.62-1.80). Significantly nonlinear associations between the 8 indexes and the risk of MetS (all Pnonlinear<.001) were observed in the RCSs. WHtR was the strongest predictor of MetS for males (AUC 0.91, 95% CI 0.90-0.92; optimal cutoff 0.53). LAP were the strongest predictor of MetS for females (AUC 0.89, 95% CI 0.89-0.90; optimal cutoff 28.67). Statistical differences were present between WHtR and all other 7 anthropometric indexes among males and overall (all P<.05). In females, the AUC values between LAP and BMI, WWI, ABSI, conicity index, VAI, and TyG index were significantly different (P<.001). No statistical difference was observed between LAP and WHtR among females.

Conclusions

According to 8 anthropometric and lipid-related indices, it is suggested that WHtR and LAP are the most appropriate indexes for identifying the presence of MetS in resource-limited areas.

Investigating the efficiency of novel indicators in predicting risk of metabolic syndrome in the Iranian adult population

BACKGROUND

Whether new anthropometric indicators are superior to conventional anthropometric indicators and whether they can better identify MetS in apparently healthy people needs further research. Thus, this study aimed to estimate the efficiency of novel indicators in predicting the risk of metabolic syndrome (MetS) in the Iranian adult population.

MATERIAL AND METHODS

In this cross-sectional study, 800 subjects were selected by clustered random sampling. The metabolic factors, traditional and novel anthropometric indices, the triglyceride and glucose index (TyG index) and modified TyG indices (TyG-BMI, TyG-WC, TyG-WHR, and TyG-WHtR), and metabolic score for insulin resistance (METS-IR) were evaluated. The MetS was calculated according to the IDF criteria. To investigate the risk of MetS, logistic regression was used along with modeling.

RESULTS

In all three models, all traditional anthropometric indices were associated with MetS (P < 0.001). Regarding novel anthropometric indices, all indices (except for ABSI) significantly predicted the risk of MetS in all participants before and after adjustment (P < 0.001). WTI index presented the highest Odds ratios for MetS (29.50, 95% CI: 15.53-56.03). A positive association was found in all models between TyG and modified TyG indices and METS-IR with MetS (P for all < 0.001). TyG-WHtR index presented the highest Odds ratios for MetS (70.07, 95% CI: 32.42-151.43).

CONCLUSION

A combination of the TyG index and WHtR (TyG-WHtR index) was better than the TyG index alone, with a higher odds ratio in predicting MetS. Due to the simplicity of these indices, cost-effectiveness, and facility at small-scale labs and being predictive of MetS risk it is suggested to include these markers in clinical practice.

Body shape index (ABSI), body roundness index (BRI) and risk factors of metabolic syndrome among overweight and obese adults: a cross-sectional study

BACKGROUND

Metabolic syndrome (MetS) is one of the most significant public health issues worldwide, which increases the risk of various diseases. Epidemiological evidence suggests that newer anthropometric measures, such as a body shape index (ABSI) and body roundness index (BRI) can be used to predict MetS. However, anthropometric measures to predict the risk for MetS should be clarified in each population. Therefore, this study aimed to examine the association between ABSI, BRI, and MetS risk factors among overweight and obese Iranian adults.

METHODS

This cross-sectional study included 347 overweight and obese individuals [body mass index (BMI) > 25 kg/m2] aged 20-50 years in Tabriz, Iran. Anthropometric measures were assessed, including BMI, waist circumference (WC), and waist-to-hip ratio (WHR). Additionally, ABSI and BRI were calculated based on the collected data. Blood pressure was measured using standard protocols. Body composition also was measured using body impedance analysis (BIA). Enzymatic-colorimetric methods were used to assess serum glucose and lipids, and enzyme-linked immunosorbent assay (ELISA) kits were used to measure insulin levels.

RESULTS

Participants with higher ABSI exhibited significantly higher systolic blood pressure (SBP) (P = 0.001), diastolic blood pressure (DBP) (P = 0.010), and triglyceride (TG) levels (P < 0.001), along with significantly lower high-density lipoprotein cholesterol (HDL-C) levels (P < 0.001). In the crude model, individuals in the highest ABSI tertile (tertile 3) had a higher likelihood of having higher SBP (OR: 1.032; 95% CI: 1.014-1.051) and DBP (OR: 1.33; 95% CI: 1.009-1.058), as well as a significant association with lower HDL-C levels (OR: 0.945; 95% CI: 0.918-0.973). Additionally, both ABSI tertile 2 (OR: 1.005; 95% CI: 1.001-1.008) and tertile 3 (OR: 0.993; 95% CI: 1.003-1.011) were linked to a higher likelihood of having higher TG levels. No significant associations were found between BRI tertiles and MetS risk factors.

CONCLUSION

According to our results, ABSI and BRI are poor predictors of MetS risk variables, in overweight and obese individuals. High ABSI is only slightly linked with high SBP, DBP, and TG and low HDL-C. However, longitudinal and long-term investigations are encouraged to verify the efficacy of these two measures.

Correlation of neck circumference, coronary calcification severity and cardiovascular events in Chinese elderly patients with acute coronary syndromes

BACKGROUND AND AIMS

We aimed to investigate whether neck circumference (NC) can predict metabolic syndrome (MetS), coronary calcification and lesion, and major adverse cardiovascular events (MACEs).

METHODS

A total of 867 patients with acute coronary syndrome (ACS) over 60 years old from the Second Hospital of Shandong University, who had undergone coronary computed tomography, were randomly selected for a retrospective analysis. The subjects were divided into male and female groups, NC quartile 1-4 groups (Q1-Q4 groups), non-multivessel coronary disease (non-MVCD) and multi-vessel coronary disease (MVCD) groups.

RESULTS

After adjusting for potential confounders, NC was associated with risk factors promoting coronary artery disease (CAD) and coronary artery calcification score (CACS). The severity of CAD increased by 0.202 times and 0.372 times for each unit of NC in male and female groups, respectively. Compared with the lower CACS group, the risk of coronary calcification increased by 0.139 times, and MVCD increased 0.268 times, with each unit increase of NC. Except for all-cause death, there were significant differences between the Q1-Q4 groups in the prevalence of all primary endpoints, cardiogenic death, unexpected re-hospitalization of heart failure, ACS recurrence or unplanned revascularization, and non-fatal stroke (p log-rank <0.01). In view of the overall trend, with the increase of NC quartiles, the prevalence of MACEs gradually increased (all p < 0.01).

CONCLUSIONS

NC is closely associated with MetS and its components, coronary calcification and lesion degree, and MACEs. NC could be used as surrogate of CACS to predict the coronary condition and prognosis of elderly patients with ACS.

Impact of anthro-metabolic indices and gestational weight gain on maternal and neonatal outcomes: a prospective observational study

OBJECTIVE

The aim of this study was to examine the relationship of anthro-metabolic indices on maternal and neonatal outcomes.

METHODS

This prospective observational study was conducted on healthy mother-baby pairs between January 1, 2023 and July 1, 2023. Detailed sociodemographic information was collected through an interview with the mother. Clinical, biochemical, obstetric, fetal, and neonatal outcomes were abstracted from hospital medical records. Anthropometric measurements were obtained from the examination of mother-baby pairs.

RESULTS

A total of 336 healthy mothers-children pairs were included. Mothers of newborn ≥4000 g had higher gestational age (p=0.003), body mass index (p=0.003), gestational weight gain (p=0.016), waist circumferences (p=0.002), and hip circumferences (p=0.001). gestational weight gain was associated with the mode of delivery (p=0.023). waist-to-hip ratio (p=0.005), gestational weight gain (p=0.013), and a body shape ındex (p<0.001) were associated with longer length of hospital stay. Age (p<0.001) and inter-pregnancy interval (p=0.004) were higher in pre-pregnancy underweight/obese mothers. Receiver operating characteristic analysis revealed that maternal waist circumferences (AUC: 0.708, p=0.005), maternal weight (AUC: 0.690, p=0.010), and hip circumferences (AUC: 0.680, p=0.015) were sufficient to predict macrosomia (p<0.05).

CONCLUSION

The study demonstrated a significant association between gestational weight gain and cesarean delivery, prolonged hospital stay, and macrosomia. It was also found that maternal body mass index, waist circumferences, and hip circumferences during pregnancy were associated with macrosomia. On the contrary, no significant relationship was found between maternal anthro-metabolic characteristics and maternal-fetal and birth outcomes.

Evaluating the performance of a novel anthropometric index: weight adjusted for waist-to-height ratio (W-WHR) - for predicting cardiometabolic risk among adults in Addis Ababa

OBJECTIVE

Various anthropometric indices had been proposed to predict cardiometabolic risk, yet few were validated in the African population. We evaluated the diagnostic accuracy of a novel anthropometric index-weight adjusted for waist-to-height ratio (W-WHR)-as a predictor of cardiometabolic risk among adults 18-64 years in Addis Ababa, Ethiopia; and compared its performance with other indices commonly used in the literature.

DESIGN

Cross-sectional study.

SETTING

Community-based study in Addis Ababa, Ethiopia.

PARTICIPANTS

Randomly selected adults (n=600) completed serum lipid, blood pressure, blood glucose and anthropometric measurements.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcomes of interest were dyslipidaemia, hypertension and hyperglycaemia. Having at least one of the three outcomes was considered as a secondary outcome. Receiver-operating characteristic curve (ROC) used to measure the diagnostic accuracy of W-WHR and another 13 indices for predicting the primary and secondary outcomes. Optimal thresholds were determined using Youden's index.

RESULTS

W-WHR demonstrated an acceptable diagnostic accuracy (area under the curve (AUC), 95% CI) for correctly classifying dyslipidaemia (0.80, 0.76 to 0.84), hypertension (0.74, 0.70 to 0.78), hyperglycaemia (0.76, 0.70 to 0.82) and the secondary outcome of interest (0.79, 0.75 to 0.83). Depending on the outcomes, thresholds between 32.6 and 36.7 concurrently maximised sensitivity and specificity of the index. ROC analysis indicated, W-WHR (AUC=0.80), abdominal volume index (AVI) (AUC=0.78) and waist circumference (WC) (AUC=0.78) for dyslipidaemia; W-WHR (AUC=0.74) and WC (AUC=0.74) for hypertension; and waist-to-height ratio (AUC=0.80) and body roundness index (AUC=0.80) for hyperglycaemia, had the highest diagnostic accuracy. Likewise, W-WHR (AUC=0.79), AVI (AUC=0.78) and WC (AUC=0.78) had better performance for the secondary outcome. Most indices have better utility among younger than older adults, and per cent body fat had the highest diagnostic accuracy among women (AUC 0.74-0.83).

CONCLUSION

W-WHR is a useful index for predicting cardiometabolic risk, especially among young adults.

Relationship between Abdominal Volume Index and Body Adiposity Index and Scales of Insulin Resistance and Metabolic Syndrome

Introduction, objectives: Obesity is a global health problem with a great negative impact on health. Among the pathologies caused by obesity are insulin resistance and metabolic syndrome, which constitute an increasingly common health problem in both developed and developing countries. The aim of this study was to examine the relationship between two scales that assess obesity-based on hip circumference-and metabolic syndrome (MetS) and insulin resistance risk scales as predictors of these alterations.

MATERIALS, METHODS

A descriptive, cross-sectional study was carried out on 193,462 workers from different Spanish regions and work groups between January 2019 and September 2021. Abdominal volume index (AVI) and body adiposity index (BAI) were evaluated to assess obesity and its association with insulin resistance using three risk scales (TyG index, Triglycerides/HDL, and METS-IR), while their association with metabolic syndrome was determined using the NCEP ATP III, IDF, and JIS models.

RESULTS

The results of the ROC curves to determine the predictive value of BAI and AVI in relation to the three criteria evaluated to calculate MetS in all instances presented a higher area under the curve (AUC) for AVI. The high values of AVI stand out for predicting MetS when applying the IDF criteria. The cut-off point in women was 13.70 with a Youden index of 0.802, whereas in men, the cut-off point was set at 17.59 with a Youden index of 0.672. Regarding the relationship of BAI and AVI with insulin resistance risk scales for both sexes, the AUC only revealed high values when using the METS-IR formula for both AVI and BAI. The AVI cut-off points to predict high values of insulin resistance risk scales in women were established at 13.12 with a Youden index of 0.722. In men, the cut-off point was 17.59, with a Youden index of 0.626. The BAI cut-off points in women were set at 33.88 with a Youden index of 0.748. In men, the cut-off point was 27.91, with a Youden index of 0.598.

CONCLUSIONS

AVI demonstrated its value as a predictor of metabolic syndrome while exclusively applying the IDF criteria. AVI and BAI demonstrated their value as predictors of high values of insulin resistance risk scales only in the case of METS-IR. This predictive value is also higher in women.

Screening tools for metabolic syndrome based on anthropometric cut-off values among Thai working adults: a community-based study

BACKGROUND

The metabolic syndrome (MetS) is a universal disease of increasing prevalence, but the prevalence varies depending on ethnicity. There is a crucial need to assess the validity of anthropometric indicators and determine appropriate cut-off values for MetS screening.

OBJECTIVE

Determine cut-off anthropometric indicators values for screening of MetS.

DESIGN

Cross-sectional SETTING: Rural and urban areas of provinces with a high prevalence of MetS in the central region of Thailand.

SUBJECTS AND METHODS

The subjects were recruited based on the International Diabetes Federation definition of MetS, which includes four anthropometric indicators. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity for different cut-off values of all novel indicators.

MAIN OUTCOME MEASURES

The cut-off values for screening of MetS, which included neck circumference (NC), body roundness index (BRI), conicity index (C-index), and body shape index (BSI).

SAMPLE SIZE

2520 participants RESULTS: The BRI and NC were the indices with higher areas under the curve, followed by the C-index and BSI. The optimal cut-off values for BRI and NC were 4.1 and 36.5 cm for males and 4.0 and 34.5 cm for females.

CONCLUSIONS

This study defined the specific cut-off values for Thai working adults.

LIMITATIONS

The participants might not be representative of all Thai adults and we may have overestimated MetS for Thai working adults because our research focus was on the highest prevalence of MetS in the central region of Thailand.

Assessing metabolic syndrome prediction quality using seven anthropometric indices among Jordanian adults: a cross-sectional study

Metabolic syndrome (MSyn) is a considerable health concern in developing and developed countries, and it is a critical predictor of all-cause mortality. Obesity, specifically central obesity, is highly associated with MSyn incidence and development. In this study, seven anthropometric indices (Body Mass Index (BMI), Waist circumference (WC), Waist-to-Height Ratio (WHtR), A Body Shape Index (ABSI), Body Roundness Index (BRI), conicity index (CI), and the Visceral Adiposity Index (VAI)) were used to identify individuals with MSyn among the Jordanian population. These indices were assessed to identify their superiority in predicting the risk of MSyn. A total of 756 subjects (410 were male and 346 were female) were met between May 2018 and September 2019 and enrolled in this study. Height, weight, and waist circumferences were measured and BMI, WHtR, ABSI, BRI, CI, and VAI were calculated. Fasting plasma glucose level, lipid profile, and blood pressure were measured. Receiver-operating characteristic (ROC) curve was used to determine the discriminatory power of the anthropometric indices as classifiers for MSyn presence using the Third Adult Treatment Panel III (ATP III) definition. MSyn prevalence was 42.5%, and obese women and men have a significantly higher prevalence. BRI and WHtR showed the highest ability to predict MSyn (AUC = 0.83 for both indices). The optimal cutoff point for an early diagnosis of MSyn was > 28.4 kg/m2 for BMI, > 98.5 cm for WC, > 5.13 for BRI, > 0.09 m11/6 kg-2/3 for ABSI, > 5.55 cm2 for AVI, > 1.33 m3/2 kg-1/2 for CI, and > 0.59 for WHtR with males having higher cutoff points for MSyn early detection than females. In conclusion, we found that WHtR and BRI may be the best-suggested indices for MSyn prediction among Jordanian adults. These indices are affordable and might result in better early detection for MSyn and thereby may be helpful in the prevention of MSyn and its complications.