What question did this study set out to answer?

The study aims to assess the diagnostic accuracy of triglyceride/HDL-c ratio and lipid accumulation product index in detecting metabolic syndrome.

February 28, 2026Archives of Endocrinology and Metabolism0 citationsOpen Access

Comparative diagnostic accuracy of the triglyceride/HDL-c ratio and lipid accumulation product index for the early detection of metabolic syndrome among adults with obesity in Indonesia: findings from the 2023 Health Survey

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Adults aged 19-64 years with obesity (BMI ≥ 25 kg/m²) in Indonesia (n=3988). Intervention: Lipid accumulation product (LAP) index and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c). Primary outcome: Diagnostic accuracy for detecting metabolic syndrome (defined by Harmonizing the Metabolic Syndrome 2009 criteria) (AUC for LAP index in men 0.842 (95% CI 0.817-0.866), AUC for TG/HDL-c in men 0.810 (95% CI 0.784-0.837); AUC for LAP index in women 0.737 (95% CI 0.720-0.755), AUC for TG/HDL-c in women 0.728 (95% CI 0.710-0.746), 95% CI See effect sizes, p=<0.001).

AAAlya Ayu Alvitananda ENEtika Ratna NoerDiponegoro University ASAhmad SyauqyTamkang University

Key Result

The lipid accumulation product index demonstrated superior accuracy (AUC 0.842) compared to the triglyceride-to-HDL cholesterol ratio (AUC 0.810) for predicting metabolic syndrome in adults with obesity in Indonesia, especially among men.

Key Points

The study aims to assess the diagnostic accuracy of triglyceride/HDL-c ratio and lipid accumulation product index in detecting metabolic syndrome.
Comparative analysis of triglyceride/HDL-c ratio and lipid accumulation product index
Focus on adults with obesity
Application of sex-specific cutoff values for enhanced accuracy
Lipid accumulation product index shows superior accuracy in identifying metabolic syndrome compared to triglyceride/HDL-c ratio
Particularly higher accuracy noted in men

Study Design

Type

Cross-Sectional (n=3,988)

Multicenter

Yes

Structured PICO

Does the lipid accumulation product index improve diagnostic accuracy for metabolic syndrome compared to the triglyceride/HDL-c ratio in Indonesian adults with obesity?

Population

3,988 adults (aged 19-64 years) with obesity (BMI ≥ 25 kg/m²) in Indonesia, mean age 41.57, 25.8% male.

Intervention

Lipid accumulation product (LAP) index

Comparator

Triglyceride/HDL-c ratio

Outcome

Diagnostic accuracy for metabolic syndrome assessed by area under the curve (AUC) of the Receiver Operating Characteristic (ROC) curvesurrogate

The lipid accumulation product index demonstrates superior diagnostic accuracy for metabolic syndrome compared to the triglyceride/HDL-c ratio among adult men with obesity in Indonesia.

Main Result

Effect estimate: AUC for LAP index in men 0.842 (95% CI 0.817-0.866), AUC for TG/HDL-c in men 0.810 (95% CI 0.784-0.837); AUC for LAP index in women 0.737 (95% CI 0.720-0.755), AUC for TG/HDL-c in women 0.728 (95% CI 0.710-0.746) (95% CI See effect sizes)

p-value: p=<0.001

Limitations

Cross-sectional design precludes causal inferences.
Potential residual confounding due to unmeasured variables such as dietary intake, medication use, comorbidities, psychological stress, and genetic predispositions.
No direct measurement of body fat or visceral fat to strengthen findings.

Abstract

The lipid accumulation product index demonstrated superior accuracy in predicting metabolic syndrome among adults with obesity, particularly among men. Sex-specific cutoff values enhance its reliability and practicality for early screening and intervention to prevent metabolic complications.

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Cite This Study

Alvitananda et al. (Thu,) conducted a cross-sectional in Adults aged 19-64 years with obesity (BMI ≥ 25 kg/m²) in Indonesia (n=3,988). Lipid accumulation product (LAP) index and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) was evaluated on Diagnostic accuracy for detecting metabolic syndrome (defined by Harmonizing the Metabolic Syndrome 2009 criteria) (AUC for LAP index in men 0.842 (95% CI 0.817-0.866), AUC for TG/HDL-c in men 0.810 (95% CI 0.784-0.837); AUC for LAP index in women 0.737 (95% CI 0.720-0.755), AUC for TG/HDL-c in women 0.728 (95% CI 0.710-0.746), 95% CI See effect sizes, p=<0.001). The lipid accumulation product index demonstrated superior accuracy (AUC 0.842) compared to the triglyceride-to-HDL cholesterol ratio (AUC 0.810) for predicting metabolic syndrome in adults with obesity in Indonesia, especially among men.

synapsesocial.com/papers/69a287570a974eb0d3c03048 https://doi.org/https://doi.org/10.20945/2359-4292-2026-0016