Precision Screening for MetS: The Role of Derived Lipid Indicators in Chinese Populations

Metabolic syndrome (MetS) is a significant public health concern among middle-aged and elderly populations in China. This study evaluates the predictive value of four derived lipid indicators-lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose (TyG) index, and Chinese visceral adiposity index (CVAI) for MetS in Chinese adults aged ≥ 45 years. Data were sourced from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Participants were classified according to the International Diabetes Federation (IDF), National Cholesterol Education Program (NCEP ATP III, 2001), and China's 2020 Guidelines for Type 2 Diabetes Prevention and Treatment. Multivariate logistic regression and ROC curve analyses assessed the predictive performance of these indicators. Results demonstrated that LAP and CVAI showed the highest predictive accuracy for MetS under the IDF criteria (AUC = 0.903), while LAP and TyG were most effective under the NCEP ATP III and China 2020 guidelines (AUC = 0.860). Subgroup analyses revealed sex- and age-specific variations in indicator effectiveness. This study suggests that derived indicators, particularly LAP and TyG, enhance the screening and management of MetS in middle-aged and elderly Chinese populations. These findings support the adoption of LAP and TyG in clinical practice to improve early detection and targeted intervention strategies.