Anthropometric Measurements to Predict Metabolic Syndrome in Thai Women With Polycystic Ovary Syndrome: A Retrospective Study

Abstract

Aim: To compare the diagnostic accuracy of seven anthropometric indices for predicting metabolic syndrome (MetS) in Thai women with polycystic ovary syndrome (PCOS). Methods: Electronic medical records of 1492 women aged 15–45 years who attended Siriraj Hospital during 2015–2024 were retrospectively analyzed. MetS was diagnosed using the International Diabetes Federation 2006 criteria. The indices assessed were a body shape index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), body mass index (BMI), body roundness index (BRI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Discrimination was evaluated by receiver operating characteristic (ROC) analysis with area under the curve (AUC) and 95% CI. Optimal cut-offs were identified using the Youden index. Results: Metabolic syndrome prevalence was 20.8%. AVI, BMI, BRI, and WHtR showed comparable discrimination (AUC 0.84–0.85) and outperformed BAI (AUC 0.79), WHR (AUC 0.78), and ABSI (AUC 0.52). A composite of AVI, BRI, and WHtR did not improve discrimination. A BMI threshold of 25.78 kg/m² provided the best overall accuracy (69.6%). A WHtR threshold of 0.53 offered similar clinical utility. Conclusions: BMI and waist-centered indices demonstrate comparable performance for predicting MetS in Thai women with PCOS. BMI provides the highest overall accuracy and, together with WHtR, can serve as practical first-line triage tools.