Simple lipid and adiposity indices show strong accuracy for spotting metabolic syndrome in Indonesian adults

A cross-sectional study of 317 adults aged 30 and older in Indonesia has found that five widely used lipid and adiposity indices all performed strongly in identifying metabolic syndrome, with no statistically significant differences between them after correction for multiple testing. The work, published in BMC Endocrine Disorders, evaluated the lipid accumulation product (LAP), the visceral adiposity index (VAI), the triglyceride-to-high-density lipoprotein ratio (TG/HDL), the triglyceride-glucose index (TyG), and the modified cardiometabolic index (MCMI).

Metabolic syndrome is a cluster of metabolic abnormalities associated with increased risk of cardiovascular disease and type 2 diabetes. It is accompanied by distinct alterations in adiposity and lipid metabolism, which has prompted researchers to develop composite indices that combine waist measurements, blood fats and glucose-related markers to improve early identification of people at elevated cardiometabolic risk. The comparative performance of these indices, however, varies across populations and between sexes, which motivated the present comparison.

The study was conducted among university-affiliated adults, with anthropometric measurements and biochemical parameters collected using standardized procedures. Metabolic syndrome was defined using Asia-Pacific waist-circumference thresholds combined with National Cholesterol Education Program Adult Treatment Panel III criteria for the remaining four components. A sensitivity analysis using the original ATP III waist-circumference thresholds was also performed, allowing the researchers to check whether the choice of waist cutoff changed the conclusions.

To assess how well each index separated people with metabolic syndrome from those without it, the team conducted receiver operating characteristic curve analysis.

Among men, AUC values ranged from 0.88 for TG/HDL, VAI and LAP to 0.91 for MCMI. Differences across the indices were not statistically significant overall (p = 0.063), and pairwise comparisons with Bonferroni correction likewise showed no statistically significant differences between individual indices. TG/HDL showed the most favorable Youden’s index among men, at 0.71.

Among women, discrimination was similarly high, with AUC values between 0.87 and 0.92. MCMI showed the numerically highest AUC at 0.92, with a Youden’s index of 0.72. As in men, pairwise comparisons with Bonferroni correction showed no statistically significant differences between individual indices, and the overall test across indices was not significant (p = 0.215).

Across indices and sexes, sensitivity ranged from 73 percent to 93 percent and specificity from 75 percent to 89 percent. These figures indicate that, at the derived cutoffs, the indices missed a minority of metabolic syndrome cases while incorrectly flagging a minority of people without the condition, though the exact trade-off depended on the index and sex.

The authors concluded that all evaluated indices demonstrated strong discriminative ability for metabolic syndrome, with broadly comparable performance between sexes. MCMI showed the numerically highest accuracy in both men and women, although pairwise differences between indices were not statistically significant after correction for multiple testing.

The researchers framed these findings as support for further evaluation of the indices as potential adjunct tools for identifying individuals at elevated cardiometabolic risk, pending external validation. As a cross-sectional study of 317 adults in a single university-affiliated setting in Indonesia, the results describe diagnostic discrimination in this population rather than establishing causal effects or clinical outcomes, and the derived cutoff values will need confirmation in other cohorts before broader use.

Subject of Research: Diagnostic performance of lipid and adiposity indices for identifying metabolic syndrome in Indonesian adults

Article Title: Comparative diagnostic performance of lipid and adiposity-related indices in identifying metabolic syndrome among university-affiliated adults in Indonesia

Article References: Huriyati, E., Nisa, A., Faza, F., Prabandari, Y. S., & Susetyowati, S. (2026). Comparative diagnostic performance of lipid and adiposity-related indices in identifying metabolic syndrome among university-affiliated adults in Indonesia. BMC Endocrine Disorders. https://doi.org/10.1186/s12902-026-02622-2

Image Credits: AI Generated

DOI: 10.1186/s12902-026-02622-2

Keywords: metabolic syndrome, lipid accumulation product, visceral adiposity index, TG/HDL ratio, TyG index, MCMI, diagnostic accuracy, AUC, cross-sectional study, Indonesia, cardiometabolic risk, adiposity