Assessing the diagnostic ability of adiposity measures to identify cardiometabolic risk factors and the metabolic syndrome in South African corporate employees.

Metabolic syndrome was prevalent in 30% of the study group and was higher in men than women.

• MetS prevalence was 30% overall in the sample of 625 corporate employees.
• MetS prevalence was 33.9% in men versus 18% in women.
• MetS was defined according to the International Diabetes Federation (IDF) criteria.
• The sample consisted of 469 men and 156 women with a mean age of 50 ± 8 years.

The AUC values for WC, WHtR, BRI, and LAP were similar to each other but higher than ABSI for both men and women in diagnosing CMD risk factors.

• Sex-stratified ROC curve analyses were used to assess the diagnostic performance of each adiposity measure.
• ABSI performed worse than WC, WHtR, BRI, and LAP for both sexes.
• WC, WHtR, BRI, and LAP showed comparable diagnostic ability to each other across CMD risk factors.

WC cut-points for CMD risk in this South African corporate population were higher than the internationally accepted IDF guidelines for both men and women.

• Derived WC cut-points were 96.5–99.5 cm for men and 86.5–92.5 cm for women.
• The internationally accepted IDF guideline cut-points are 94 cm for men and 80 cm for women.
• These findings suggest the IDF thresholds may not be optimally calibrated for this specific population.

Cut-points for WHtR, BRI, and ABSI were similar between sexes, while LAP cut-points were higher in men than women.

• WHtR cut-point was 0.6 for both sexes.
• BRI cut-point was 4.5 for both sexes.
• ABSI cut-points were 0.08 for men and 0.07 for women.
• LAP cut-points were 45.5–53.5 for men and 22.8–41.5 for women, indicating sex differences in lipid accumulation thresholds.

In men, BRI was most strongly associated with MetS after accounting for confounders, while in women, LAP showed the strongest association.

• In men, BRI had an odds ratio of 2.5 (95% CI: 1.9–3.3) for MetS.
• In women, LAP had an odds ratio of 3.4 (95% CI: 1.4–8.4) for MetS.
• These associations were determined using logistic regression analyses adjusted for confounders.
• The sex-specific differences suggest that different adiposity measures may be more diagnostically relevant depending on sex.

The study used a cross-sectional design with health risk assessments completed on 625 South African corporate employees.

• The sample included 469 men and 156 women.
• Mean age of participants was 50 ± 8 years.
• Adiposity measures assessed included WC, WHtR, BRI, ABSI, and LAP.
• Sex-stratified ROC curve and logistic regression analyses were the primary statistical methods.