Abstract
BACKGROUND: Female healthcare workers have unique occupational stressors and lifestyle factors that may increase their risk of metabolic disorders. This study aimed to investigate the utility of the fatty liver index (FLI) as a predictor of metabolic syndrome among female employees in the healthcare sector. METHODS: This cross-sectional study included 450 female healthcare workers aged ≥18 years, employed in various roles at a tertiary healthcare facility in Gujarat. Clinical examination, anthropometric measurements, and biochemical tests were conducted. FLI was calculated, and metabolic syndrome was diagnosed using harmonized criteria. Logistic regression analysis evaluated predictors. RESULTS: The mean age was 44.2 ± 7.8 years, and the prevalence of metabolic syndrome was 61%. Increasing the FLI category was significantly associated with a worsening metabolic profile. The odds of hypertension, diabetes, metabolic syndrome, and cardiovascular disease progressively increased with higher FLI levels (P < 0.001), denoting a dose-response relationship. FLI demonstrated good diagnostic accuracy for metabolic syndrome with an area under the curve (AUC) of 0.86 (95% CI: 0.81 - 0.89). An FLI cutoff ≥30 provided an optimal balance of sensitivity (71%) and specificity (41%) for predicting metabolic syndrome. CONCLUSION: FLI demonstrates a strong association with metabolic syndrome and related comorbidities in a dose-dependent manner. FLI can be a simple, low-cost screening tool to identify high metabolic risk individuals in resource-limited settings.