Validation of a non-invasive method for the early detection of metabolic syndrome: a diagnostic accuracy test in a working population

BMJ Open. 2018 Oct 21;8(10):e020476. doi: 10.1136/bmjopen-2017-020476.

Abstract

Objectives: A non-invasive method for the early detection of metabolic syndrome (NIM-MetS) using only waist-to-height ratio (WHtR) and blood pressure (BP) has recently been published, with fixed cut-off values for gender and age. The aim of this study was to validate this method in a large sample of Spanish workers.

Design: A diagnostic test accuracy to assess the validity of the method was performed.

Setting: Occupational health services.

Participants: The studies were conducted in 2012-2016 on a sample of 60 799 workers from the Balearic Islands (Spain).

Interventions: The NCEP-ATP III criteria were used as the gold standard. NIM-MetS has been devised using classification trees (the χ2 automatic interaction detection method).

Main outcome measures: Anthropometric and biochemical variables to diagnose MetS. Sensitivity, specificity, validity index and Youden Index were determined to analyse the accuracy of the diagnostic test (NIM-MetS).

Results: With regard to the validation of the method, sensitivity was 54.7%, specificity 94.9% and the Validity Index 91.2%. The cut-off value for WHtR was 0.54, ranging from 0.51 (lower age group) to 0.56 (higher age group). Variables more closely associated with MetS were WHtR (area under the curve (AUC)=0.85; 95% CI 0.84 to 0.86) and systolic BP (AUC=0.79; 95% CI 0.78 to 0.80)). The final cut-off values for the non-invasive method were WHtR ≥0.56 and BP ≥128/80 mm Hg, which includes four levels of MetS risk (very low, low, moderate and high).

Conclusions: The analysed method has shown a high validity index (higher than 91%) for the early detection of MetS. It is a non-invasive method that is easy to apply and interpret in any healthcare setting. This method provides a scale of MetS risk which allows more accurate detection and more effective intervention.

Keywords: cardiovascular risk; early detection; metabolic syndrome; non-invasive method; working population.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anthropometry*
  • Body Mass Index
  • Cross-Sectional Studies
  • Early Diagnosis*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Metabolic Syndrome / diagnosis*
  • Middle Aged
  • Occupational Health Services
  • ROC Curve
  • Sensitivity and Specificity
  • Sex Factors
  • Spain
  • Waist Circumference
  • Waist-Hip Ratio
  • Young Adult

Associated data

  • Dryad/10.5061/dryad.cb51t54