Anthropometric Measurements to Predict Metabolic Syndrome in Thai Women With Polycystic Ovary Syndrome: A...

To compare the diagnostic accuracy of seven anthropometric indices for predicting metabolic syndrome (MetS) in Thai women with polycystic ovary syndrome (PCOS).

Electronic medical records of 1492 women aged 15-45 years who attended Siriraj Hospital during 2015-2024 were retrospectively analyzed. MetS was diagnosed using the International Diabetes Federation 2006 criteria. The indices assessed were a body shape index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), body mass index (BMI), body roundness index (BRI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Discrimination was evaluated by receiver operating characteristic (ROC) analysis with area under the curve (AUC) and 95% CI. Optimal cut-offs were identified using the Youden index.

Metabolic syndrome prevalence was 20.8%. AVI, BMI, BRI, and WHtR showed comparable discrimination (AUC 0.84-0.85) and outperformed BAI (AUC 0.79), WHR (AUC 0.78), and ABSI (AUC 0.52). A composite of AVI, BRI, and WHtR did not improve discrimination. A BMI threshold of 25.78 kg/m² provided the best overall accuracy (69.6%). A WHtR threshold of 0.53 offered similar clinical utility.

BMI and waist-centered indices demonstrate comparable performance for predicting MetS in Thai women with PCOS. BMI provides the highest overall accuracy and, together with WHtR, can serve as practical first-line triage tools.