Comparative discriminatory performance of anthropometric indices for blood pressure and random capillary glucose measures among semi-urban Nigerian adults

To compare the screening performance of conventional and emerging anthropometric indices for identifying blood-pressure and exploratory random capillary glucose categories among semi-urban Nigerian adults. This cross-sectional analysis included 6,027 adults attending outreach programmes in Northcentral Nigeria between 2019 and 2023. Eight indices were evaluated: body mass index, waist circumference (WC), waist-to-height ratio, Conicity Index, Relative Fat Mass (RFM), A Body Shape Index, Body Roundness Index and Weight-Adjusted Waist Index. Blood pressure was classified using 2024 European Society of Cardiology thresholds. Single non-fasting capillary glucose measurements were analysed continuously and in exploratory, non-diagnostic categories. Analyses used age- and sex-adjusted ordinal logistic regression and receiver operating characteristic curves. Mean age was 49.0 (SD 15.9) years; 75.8% were female. Elevated and hypertensive-range blood pressure occurred in 55.9% and 42.1%, respectively; 6.6% had glucose ≥ 11.1 mmol/L. All indices were associated with both outcomes; RFM showed the strongest adjusted associations. WC had the highest observed AUC for hypertensive-range blood pressure (0.633), and Conicity Index for glucose ≥ 11.1 mmol/L (0.578). Discrimination was modest for blood pressure and poor for glucose. Anthropometric measures should complement direct blood-pressure measurement and confirmatory glycaemic testing. Female predominance limits generalisability, particularly to men. Exploratory thresholds require validation in representative populations.