Evaluation of body mass index, waist-to-hip ratio, and waist-to-height ratio as predictors of insulin resistance in Syrian adult women: A cross-sectional study

Objective Body mass index, waist-to-hip ratio, and waist-to-height ratio are widely used anthropometric indices for assessing obesity-related metabolic risk; however, their relative contributions to insulin resistance remain debated and vary across different ethnicities. Methods This prospective cross-sectional study evaluated the correlations of body mass index, waist-to-hip ratio, and waist-to-height ratio with insulin resistance, measured by the homeostasis model assessment of insulin resistance, among 70 Syrian adult women aged 17–46 years who were consecutively recruited from the outpatient clinic in Homs governorate. Results Scatter plots and correlation analyses were performed indicating that different anthropometric parameters are associated, to varying degrees, with the occurrence and progression of insulin resistance. Among studied anthropometric obesity indicators, body mass index has a weak, non-significant correlation with homeostasis model assessment of insulin resistance (r = 0.18, p = 0.1338), whereas waist-to-height ratio (r = 0.62, p = 0.0001) was found to be the most closely associated with occurrence of insulin resistance. Receiver operating characteristic analysis further demonstrated that waist-to-height ratio had the highest predictive accuracy for insulin resistance (area under the curve = 0.82), outperforming body mass index (area under the curve = 0.78) and waist-to-hip ratio (area under the curve = 0.74). Conclusion Therefore, waist-to-height ratio appears to be a simple and effective anthropometric tool for identifying individuals at higher risk of insulin resistance in Syrian adult women. However, as our study was only conducted on women, further investigations in men are warranted to justify its widespread adoption in clinical practice.