Predictive Diagnostic Power of Anthropometric Indicators for Metabolic Syndrome: A Comparative Study in Korean Adults

Background/Objectives: Metabolic syndrome (MetS) is a cluster of risk factors that significantly increase the risk of cardiovascular disease, including type 2 diabetes, etc. Assessing the predictive diagnostic power of anthropometric indicators for MetS is crucial for the early identification and prevention of related health issues. This study focuses on the Korean adult population while providing insights that may be applicable to broader global contexts. Therefore, this study aimed to compare the predictive diagnostic capabilities of various anthropometric indicators, including body mass index (BMI), waist-to-height ratio (WHtR), muscle mass-to-fat mass ratio (MFR), muscle mass-to-waist ratio (MWR), and body shape index (ABSI), in relation to MetS in Korean adults. Methods: Data from 13,725 participants of the Korea National Health and Nutrition Examination Survey (2008-2011) were analyzed. The diagnostic power of each indicator was assessed using the receiver operating characteristic (ROC) curve analysis, and the area under the curve (AUC) values were compared. Participants were classified into normal (NG) and abnormal (AG) groups based on established cutoff values, and logistic regression analysis was performed to evaluate the odds of MetS in each group. Results: WHtR showed the highest AUC values (0.792 for men and 0.768 for women), indicating superior diagnostic accuracy compared to the other indicators (p < 0.001). Logistic regression analysis indicated that both the unadjusted and adjusted odds ratios (OR) for MetS were significantly higher in the AG than in the NG across all indicators (p < 0.001). Specifically, the adjusted OR (95% confidence interval) for WHtR in the AG was 6.793 (5.929-7.784) for men and 4.665 (4.151-5.423) for women, representing the highest values among all indicators (p < 0.001). Conclusion: Among the various anthropometric indicators, WHtR is the most reliable and practical for predicting MetS in Korean adults. It is useful for early intervention and prevention in both clinical and public health settings.