Obesity- and lipid-related indices as a predictor of obesity metabolic syndrome in a national cohort study

Abstract

ObjectiveMetabolic syndrome is a common condition among middle-aged and elderly people. Recent studies have reported the association between obesity- and lipid-related indices and metabolic syndrome, but whether those conditions could predict metabolic syndrome is still inconsistent in a few longitudinal studies. In our study, we aimed to predict metabolic syndrome by obesity- and lipid-related indices in middle-aged and elderly Chinese adults.MethodA national cohort study that consisted of 3,640 adults (≥45 years) was conducted. A total of 13 obesity- and lipid-related indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), conicity index (CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), and triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, and TyG-WHtR), were recorded. Metabolic syndrome (MetS) was defined based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III (2005). Participants were categorized into two groups according to the different sex. Binary logistic regression analyses were used to evaluate the associations between the 13 obesity- and lipid-related indices and MetS. Receiver operating characteristic (ROC) curve studies were used to identify the best predictor of MetS.ResultsA total of 13 obesity- and lipid-related indices were independently associated with MetS risk, even after adjustment for age, sex, educational status, marital status, current residence, history of drinking, history of smoking, taking activities, having regular exercises, and chronic diseases. The ROC analysis revealed that the 12 obesity- and lipid-related indices included in the study were able to discriminate MetS [area under the ROC curves (AUC > 0.6, P < 0.05)] and ABSI was not able to discriminate MetS [area under the ROC curves (AUC < 0.6, P > 0.05)]. The AUC of TyG-BMI was the highest in men, and that of CVAI was the highest in women. The cutoff values for men and women were 187.919 and 86.785, respectively. The AUCs of TyG-BMI, CVAI, TyG-WC, LAP, TyG-WHtR, BMI, WC, WHtR, BRI, VAI, TyG index, CI, and ABSI were 0.755, 0.752, 0.749, 0.745, 0.735, 0.732, 0.730, 0.710, 0.710, 0.674, 0.646, 0.622, and 0.537 for men, respectively. The AUCs of CVAI, LAP, TyG-WC, TyG-WHtR, TyG-BMI, WC, WHtR, BRI, BMI, VAI, TyG-index, CI, and ABSI were 0.687, 0.674, 0.674, 0.663, 0.656, 0.654, 0.645, 0.645, 0.638, 0.632, 0.607, 0.596, and 0.543 for women, respectively. The AUC value for WHtR was equal to that for BRI in predicting MetS. The AUC value for LAP was equal to that for TyG-WC in predicting MetS for women.ConclusionAmong middle-aged and older adults, all obesity- and lipid-related indices, except ABSI, were able to predict MetS. In addition, in men, TyG-BMI is the best indicator to indicate MetS, and in women, CVAI is considered the best hand to indicate MetS. At the same time, TyG-BMI, TyG-WC, and TyG-WHtR performed better than BMI, WC, and WHtR in predicting MetS in both men and women. Therefore, the lipid-related index outperforms the obesity-related index in predicting MetS. In addition to CVAI, LAP showed a good predictive correlation, even more closely than lipid-related factors in predicting MetS in women. It is worth noting that ABSI performed poorly, was not statistically significant in either men or women, and was not predictive of MetS.

Association of adiposity-and lipid-related indices with metabolic syndrome among older adults in the coastal city of China: A population-based study

“…Our study showed that a higher load of adiposity indices and lipid-related indices were associated with MetS independent of sociodemographic, behavioral, and clinical factors. This was in line with reports from the China Health and Retirement Longitudinal Study (CHARLS) survey, which showed the correlation of the higher WC, BMI, WHtR, VAI, ABSI, BRI, LAP, ConI, CVAI, TyG-index and their combined indices (TyG-BMI, TyG-WC, TyG-WHtR) with MetS in middle-aged and elderly Chinese adults [21,31]. The National Health and Nutrition Examination Survey (NHANES) study also found that lipid-related indices, such as LAP, VAI, and TyG index with MetS in older adults [18].…”

“…Especially, TyG-WHtR, as a novel lipid combined anthropometric indices, seem to be a superior indicator of MetS in the Chinese population in comparison with other anthropometric indices to screen MetS. This was consistent with the two population-based studies from Nigerians and China, which suggested TyG-related indices integrated the TyG index and anthropometric characteristics enhanced MetS identi cation and prediction [21,31,37]. Early detection of individuals at high risk for MetS remains a clinical priority, offering the potential for timely interventions that may mitigate complications and improve patient prognosis.…”

“…However, another cross-sectional study found that TyG index were reliable surrogate markers for identifying MetS in middle-aged and elderly Chinese [19]. The China Health and Retirement Longitudinal Study (CHARLS) study found that TyG-BMI, TyG-WC, and TyG-WHtR performed better than BMI, WC, and WHtR in predicting MetS in middle-aged and early older adults (≥ 45 years of age) [20,21]. Currently, NHANES found that a non-linear trend between TyG index and TyG-WC indices with all-cause mortality of the MetS population in America [22].…”

Association between triglyceride-glucose index and all-cause mortality in critically ill patients with ischemic stroke: analysis of the MIMIC-IV database

“…TyG index provided an available approach to analyze the both of lipid metabolism and glucose status [ 16 , 17 ]. Previous studies mostly concentrate on the level of TyG index in the general population to predict the adverse outcomes of CAD and CVD [ 11 , 12 ].…”

Using anthropometric parameters to predict insulin resistance among patients without diabetes mellitus

“…A cross-sectional study including 2,255 participants with IR and 7,629 participants with non-IR showed that the ratio of triglyceride-glucose to WHtR (TyG-WHtR) is a stable indicator for identifying IR and can be effectively used in clinical practice 18 . Another study conducted in China showed that among all 12 indicators related to blood lipids and obesity, the ratio of triglycerides-glucose to BMI (TyG-BMI) is the best predictor of male metabolic syndrome 19 . In addition, anthropometric parameters combined with triglycerides-glucose were better predictors of metabolic syndrome than anthropometric parameters alone.…”