Abstract
BACKGROUND: This study aimed to develop and validate models for identifying individuals at high risk for metabolic syndrome (MetS) and pre-MetS using easily collectible indices. METHODS: A cross-sectional analysis was conducted using data from the Ningxia Cardiovascular Disorders Survey (NCDS) in China, collected between January 2020 and December 2021. The study population comprised 10,520 participants with complete demographic, anthropometric, and laboratory data. The diagnostic models for MetS were developed using five easily collectible indicators. The performance of the models was compared with that of Lipid Accumulation Product (LAP), Triglyceride-Glucose (TyG) Index, and Waist-to-Height Ratio (WHtR). These same models were subsequently applied to pre-MetS detection as a secondary analysis. Area under the receiver operating characteristic curve (AUC), Hosmer and Lemeshow test, bootstrap method, Brier score and Decision Curve Analysis were employed to evaluate the performance of the models. RESULTS: Model 1 comprised factors such as WC, SBP, DBP and gender. In contrast, Model 2 included all the variables from Model 1 while additionally incorporating FPG. In the training set, the AUC for Model 1 and Model 2 were 0.914 and 0.924, respectively. The AUC for Model 1 and Model 2 in identifying the presence of pre-MetS and MetS conditions were 0.883 and 0.902, respectively. In the external validation set, the AUC for Model 1 and Model 2 in identifying the presence of MetS were 0.929 and 0.934, respectively. For detecting pre-MetS and MetS conditions, the AUC for Model 1 and Model 2 were 0.885 and 0.902, respectively. Compared to TyG, LAP, and WHtR, model 1 and 2 exhibited a superior ability to identify MetS as well as pre-MetS and MetS conditions in both the training and validation sets. CONCLUSIONS: Our models offered an easy, accurate and efficient tool for identifying MetS and pre-MetS, which might be used in large-scale population screening or self-health management at home.