Objective To evaluate the predictive value of different anthropometric indicators and their combinations on the risk for metabolic syndrome (MetS) in general population.

Methods In April 2019, questionnaire survey and anthropometric measurement were conducted in 3477 residents aged 18-69 years selected through four-stage cluster sampling in Shandong province to understand the prevalence of MetS in local population, and the independent and combined predictive value of anthropometric indicators on the risk for MetS were analyzed.

Results All the anthropometric indicators body mass index (BMI), waist circumference (WC), waist-to-hip ratio (whr), waist-to-height ratio (WtHR), conicity index (CI), body shape index (ABSI), body roundness index (BRI), abdominal volume index (AVI) detected in the MetS group were significantly higher than those detected in the non-MetS group (P<0.001). The results of logistic regression analysis of model 2 showed that WC Z-score had the largest odds ratio (OR) value (3.73) in men 95% confidence interval (CI): 2.80−4.97 and WtHR Z-score had the largest OR value (2.70) in women (95%CI: 2.13−3.42). Receiver operating characteristic (ROC) curve analysis showed the largest area under curve (AUC) for WC and AVI were all at 0.83 (95%CI: 0.80−0.85) in men, and the largest AUC for WC, WtHR, BRI and AVI were all 0.82 in women. WC, WtHR, BRI and AVI were divided into high and low levels according to the best cut-off value, and the OR was greatest when high level of WC was combined with high level of WtHR, BRI or AVI; The sensitivity, specificity and positive predictive value (PPV) of combination of WC and AVI were similar to WC (sensitivity 91.44%, specificity 64.88%, PPV 44.95% in men, sensitivity 90.85%, specificity 63.80%, PPV 32.58% in women). The specificity and positive predictive values were significantly improved for the high value combination of WC with WtHR or BRI, the sensitivity was significantly reduced in men (high WC plus high WtHR: sensitivity 69.28%, specificity 79.78%, PPV 51.92%; high WC plus high BRI: sensitivity 71.23%, specificity 78.73%, PPV 51.23%); The same trends were observed in women, but the degrees were smaller.

Conclusion The combination of WC with WtHR or BRI can improve the specificity and positive predictive value of predicting the risk for MetS. In the management of chronic disease in key population, it can be applied for the screening population at high-risk for MetS.