Anthropometric and glycemic markers for discriminating of metabolic syndrome in patients with dyspepsia: a cross-sectional study

Metabolic syndrome (MetS) increases gastrointestinal morbidity; however, its diagnostic markers in patients with dyspepsia are underexplored. We aimed to determine the diagnostic performance and discriminatory ability of anthropometric and glycemic markers for MetS in adults with dyspepsia. This cross-sectional study included 100 consecutive adults with dyspepsia who underwent upper gastrointestinal endoscopy at a public center in Imperatriz, Brazil (October 2022-January 2023). Sociodemographic data, anthropometry (body mass index [BMI], neck and hip circumferences, and waist-to-hip ratio [WHR]), and biochemical variables (fasting glucose, triglycerides, and HbA1c) were collected. MetS was defined according to the International Diabetes Federation criteria. Associations were assessed using Pearson’s chi-squared or Mann–Whitney tests, and discriminatory ability was quantified using receiver operating characteristic (ROC) curves. The prevalence of metabolic syndrome was 32.0%. Age > 44 years increased MetS odds (odds ratio [OR] 3.35; 95% confidence interval [CI] 1.41–7.95; p = 0.005), whereas regular physical activity was protective (OR 0.40; 0.16–0.98; p = 0.039). Compared with non-MetS participants, those with MetS displayed higher median values for BMI (28.0 vs. 22.9 kg/m²), neck circumference (37.0 vs. 34.0 cm), hip circumference (106 vs. 97 cm), WHR (0.92 vs. 0.86), HbA1c (5.6% vs. 5.3%) and triglyceride–glucose (TyG) index (8.9 vs. 8.3) (all p ≤ 0.023). ROC analysis showed very good discrimination for TyG index (area under the curve [AUC] 0.862; optimal cut-off ≥ 8.71), good discrimination for BMI (AUC 0.793), hip circumference (AUC 0.748) and WHR (AUC 0.734), and sufficient accuracy for neck circumference (AUC 0.680) and HbA1c (AUC 0.640). One in three patients with dyspepsia met the MetS criteria. The TyG index, an inexpensive surrogate for insulin resistance, showed the strongest discriminatory performance, followed by BMI and hip- or waist-related indices. Routine use of the TyG index (cut-off ≥ 8.71) together with simple anthropometry may enable early MetS detection and tailored preventive strategies in gastroenterology practice, although this cut-off is population-specific and exploratory and should be externally validated before widespread clinical implementation.