Obesity indices as predictors of metabolic syndrome: 1-year findings from a Peruvian cohort of private educational institution workers

Background: Metabolic syndrome (MetS) is a common condition marked by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. It has significant health and economic impacts, highlighting the need for early predictive markers. Objective: To compare the prognostic performance of various obesity indices in the 1-year incidence of MetS among adult employees of a private educational institution. Design: Cohort study. Methods: A prospective cohort study was conducted using data from adults employed at a private educational institution in Lima, Peru. Participants were enrolled in 2019 and followed for 1 year to monitor anthropometric and biochemical parameters. The outcome was the development of MetS at the end of follow-up, defined according to the criteria of the Latin American Diabetes Association. Receiver operating characteristic curves were plotted, and the area under the curve (AUC) with 95% confidence intervals (CI) was calculated to assess the predictive utility of each index for MetS after 1 year. Results: Of the 792 adults initially enrolled, 475 were included in the final analysis after exclusions and loss to follow-up. Their average age was 38.4 years, and 54.3% were women. The overall incidence of MetS was 7.4%, with 12% for males and 4% for females. The highest AUC values for predicting MetS were observed for the body mass index (AUC: 0.88; 95% CI: 0.84–0.92), waist-to-height ratio (WHtR; AUC: 0.89; 95% CI: 0.85–0.92), abdominal volume index (AVI; AUC: 0.89; 95% CI: 0.86–0.92), and body roundness index (BRI; AUC: 0.89; 95% CI: 0.85–0.92). In sex-stratified analyses, results were consistent for males. Among females, the body adiposity index also showed good discrimination (AUC: 0.91; 95% CI: 0.83–1.00). The wide 95% CI reflects the small number of incident MetS cases among women (n = 10) and should be interpreted with caution. Conclusion: In conclusion, the incidence of MetS after 1 year of follow-up was 7.4%, with a higher rate among males. The WHtR, BRI, and AVI were the most useful anthropometric indices for predicting MetS.