Diagnostic Accuracy and Clinical Utility of an Ayurvedic Questionnaire for Predicting Metabolic Syndrome

Background: Metabolic syndrome (MetS) is frequently underdetected despite cardiometabolic risk. A validated 13-item Medovaha Srotas Dushti (MSD) questionnaire operationalises an Ayurvedic construct of lipid-metabolic dysfunction, but its clinical concordance with biomedical MetS criteria requires evaluation. Objective: This study aimed to determine the association between MSD and MetS and to assess the diagnostic accuracy of the MSD questionnaire against National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) 2005 criteria. Methods: In an 18-month cross-sectional analytical study conducted at Shri Ayurveda Hospital, Nagpur, and its peripheral outreach settings (including hospital- and community-based participants), 218 adults aged 31-60 years were screened and 90 enrolled. Eligible participants meeting the inclusion criterion (age 31-60 years) completed the MSD questionnaire (dichotomous scoring); scores ≥70% (≥9 out of 13) were classified as MSD-positive. Anthropometry, blood pressure, fasting glucose, triglycerides, and high-density lipoprotein (HDL) cholesterol were measured. Associations were tested using chi-square (χ²) and risk ratios (RRs); logistic regression adjusted for obesity grade and sex. Diagnostic indices and Cohen’s kappa (κ) were calculated. Results: MetS was present in 53.3% of participants. MSD-positive participants showed significantly higher adiposity measures, blood pressure, triglycerides, and fasting glucose, and lower HDL (all p < 0.001). MSD was strongly associated with MetS (χ² = 64.46, p = 0.001; RR = 18.81, 95% CI 4.85-73). The questionnaire demonstrated 95.56% sensitivity, 88.89% specificity, and 92.22% overall accuracy with excellent agreement (κ = 0.844). Conclusion: MSD was significantly associated with MetS, and the MSD questionnaire demonstrated high diagnostic agreement with NCEP-ATP III criteria. These findings suggest its potential as a non-invasive adjunct screening tool for identifying individuals at increased metabolic risk. However, results should be interpreted cautiously due to the cross-sectional design; they do not establish causality or independent predictive validity and require further validation in larger longitudinal studies.