Abstract
Background: Metabolic syndrome (MetS) predispose to risks of cardiovascular disease (CVD), diabetes mellitus and related disorders. MetS diagnosis varies across geographic zones and requires measurement of multiple factors such as anthropometry, blood pressure (BP), serum lipids, fasting plasma glucose. This study aims to evaluate the MetS diagnostic utility of lipid ratios like total cholesterol/HDL cholesterol ratio (TC/HDLc), triglyceride/HDL cholesterol ratio (TG/HDLc), LDLc cholesterol/HDL cholesterol ratio (LDLc/HDLc), Non-HDL cholesterol (NonHDLc) and novel metabolic indices like lipid accumulation product (LAP), visceral adiposity index (VAI), cardiometabolic index (CMI), triglyceride glucose (TyG) index.
Materials and Methods: This cross sectional study included 60 healthy adults visiting the health checkup clinic of a tertiary care hospital in South India. MetS diagnosis in subjects was based on the harmonising definition with South Asian waist circumference (WC) cutoff levels. The lipid ratios, novel metabolic indices were compared between MetS cases and controls without MetS using unpaired t-test or Mann-Whitney test. Simple logistic regression and ROC curve analyses were performed to determine usefulness of the studied indices.
Results: MetS was diagnosed in 39 (65%) participants and 51 (85%) participants had central obesity. TC/HDLc ratio, TG/HDLc ratio, LDLc/HDLc ratio, LAP, VAI, CMI, TyG were very much elevated in MetS cases and showed significantly associations with occurrence of MetS. Of all the studied indices, TyG had strongest association (OR > 1*) with greatest AUC of 0.801*, while highest Youden index of 0.56* was observed with LAP.
Conclusion: TyG and LAP are the most reliable novel metabolic indices to predict MetS in South Indian subjects.

Key words: Triglyceride glucose index, Lipid accumulation product, Cardiometabolic index, Lipid ratios, Metabolic syndrome