Comparative Evaluation of Lipid Accumulation Product Index, Visceral Adiposity Index, and Triglyceride Waist Circumference as Risk Predictors of Metabolic Syndrome

Background: Metabolic syndrome (MetS) is a major public health concern associated with an increased risk of type 2 diabetes mellitus and cardiovascular disease.Lipid-related surrogate indices such as the lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose waist circumference (TyG-WC) index have been proposed as simple markers of visceral adiposity and metabolic risk.However, comparative evidence regarding their diagnostic performance in Indian adults remains limited.Objectives: To compare the association and diagnostic performance of LAP, VAI, and TyG-WC in identifying MetS in an adult Indian population.Materials and methods: This hospital-based cross-sectional study included 93 adults aged 20-60 years (60 with MetS and 33 controls).Anthropometric measurements, blood pressure, and fasting biochemical parameters were recorded.Lipid accumulation product, VAI, and TyG-WC were calculated using standard formulas.Group comparisons were performed using appropriate parametric or nonparametric tests.Associations with MetS were assessed using Spearman correlation analysis.Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and multivariable logistic regression was used to assess independent associations after adjusting for age, sex, body mass index (BMI), and smoking status.Results: Participants with MetS had significantly higher waist circumference (WC), blood pressure, fasting glucose, triglyceride levels, LAP, and TyG-WC values compared with controls (p < 0.001).Visceral adiposity index, LAP, and TyG-WC demonstrated strong positive correlations with MetS, whereas VAI showed a comparatively weaker association.Receiver operating characteristic analysis revealed excellent discriminative ability for LAP (AUC = 0.927) and TyG-WC (AUC = 0.896), followed by VAI (AUC = 0.862).Lipid accumulation product showed the best balance of sensitivity and specificity, whereas TyG-WC demonstrated the highest sensitivity.After adjustment for confounders, none of the lipid indices were independently associated with MetS.Conclusion: Lipid accumulation product, TyG-WC, and VAI are significantly associated with MetS and demonstrate good to excellent diagnostic performance.Lipid accumulation product provides the most balanced diagnostic accuracy, while TyG-WC may be particularly useful for screening due to its high sensitivity.These indices may complement traditional risk assessment tools; however, prospective studies are needed to establish their independent prognostic value.