Lipid-adiposity indices outperform traditional and derived anthropometric and biochemical indices for discriminating individuals with metabolic syndrome

Why clinicians should know about it

• Picked for Biochemistry (medical) (paper of the day, 18 August 2026): Lipid‑adiposity indices outperform traditional MetS markers

Abstract

BACKGROUND: The most common traditional anthropometric indices used for metabolic syndrome (MetS) screening may not capture the metabolic risks associated with central adiposity, lipid dysregulation, and sex-specific metabolic risk. The purpose of this study was to compare traditional and derived anthropometric and biochemical parameters in the diagnosis of MetS among Jordanian adults. METHODS: In this cross-sectional study, 930 adults (458 men and 472 women), aged 20-70 years, were assessed using harmonized IDF and AHA/NHLBI criteria. Among the traditional anthropometric indices, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) were included. Several derived indices were computed: lipid accumulation product (LAP), visceral adiposity index (VAI), body roundness index (BRI), abdominal volume index (AVI), atherogenic index of plasma (AIP), cardiac risk index (CRI), and related lipid ratios. The diagnostic accuracy was verified using receiver operating characteristic (ROC) curve analysis, sensitivity, specificity, and the Youden index in sex-stratified analyses. RESULTS: Among traditional indices, the results for WC and WHtR were good. The derived indices LAP and VAI were most accurate in both sexes, while the lipid ratios alone failed to provide good discrimination. BRI and AVI also showed good performance in derived anthropometric indices. Significant sex-specific differences were found in index distributions, optimal cutoff values, and their associations with MetS components. CONCLUSION: Derived lipid-adiposity indices are more discriminatory towards MetS than traditional single anthropometric indices, especially LAP and VAI. WC and WHtR are still good first-line screening tools while biochemical measurements may be used in the stratification of risk with LAP and VAI. The results of this study suggest the need for a multi-dimensional, sex-specific approach to screening for metabolic syndrome. The proposed cut-off values are based on a Jordanian population. Still, the approach of combining anthropometric, biochemical, and imaging-based surrogate markers for metabolic assessment may be transferable to other populations after external validation.

Abstract as published, via PubMed.