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Validation of a non-invasive method for the early detection of metabolic syndrome: a diagnostic accuracy test in a working population
  1. Manuel Romero-Saldaña1,
  2. Pedro Tauler2,3,
  3. Manuel Vaquero-Abellán4,
  4. Angel-Arturo López-González5,
  5. Francisco-José Fuentes-Jiménez6,7,
  6. Antoni Aguiló3,8,
  7. Carlos Álvarez-Fernández1,
  8. Guillermo Molina-Recio9,
  9. Miquel Bennasar-Veny3,8
  1. 1 Department of Occupational Safety and Health, Córdoba City Hall, Córdoba, Spain
  2. 2 Department of Fundamental Biology and Health Sciences, University of the Balearic Islands, Palma, Spain
  3. 3 Research Group on Evidence, Lifestyles & Health, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
  4. 4 Department of Occupational Risk Prevention and Environmental Protection, University of Córdoba, Córdoba, Spain
  5. 5 Prevention of Occupational Risks in Health Services, Balearic Islands Health Service, Palma, Spain
  6. 6 IMIBIC, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
  7. 7 CIBER Physiopathology of Obesity and Nutrition CIBEROBN, ISCIII, Madrid, Spain
  8. 8 Nursing and Physiotherapy Department, University of the Balearic Islands, Palma, Spain
  9. 9 Department of Nursing, School of Medicine and Nursing, University of Córdoba, Córdoba, Spain
  1. Correspondence to Dr Pedro Tauler; pedro.tauler{at}


Objectives A non-invasive method for the early detection of metabolic syndrome (NIM-MetS) using only waist-to-height ratio (WHtR) and blood pressure (BP) has recently been published, with fixed cut-off values for gender and age. The aim of this study was to validate this method in a large sample of Spanish workers.

Design A diagnostic test accuracy to assess the validity of the method was performed.

Setting Occupational health services.

Participants The studies were conducted in 2012–2016 on a sample of 60 799 workers from the Balearic Islands (Spain).

Interventions The NCEP-ATP III criteria were used as the gold standard. NIM-MetS has been devised using classification trees (the χ2 automatic interaction detection method).

Main outcome measures Anthropometric and biochemical variables to diagnose MetS. Sensitivity, specificity, validity index and Youden Index were determined to analyse the accuracy of the diagnostic test (NIM-MetS).

Results With regard to the validation of the method, sensitivity was 54.7%, specificity 94.9% and the Validity Index 91.2%. The cut-off value for WHtR was 0.54, ranging from 0.51 (lower age group) to 0.56 (higher age group). Variables more closely associated with MetS were WHtR (area under the curve (AUC)=0.85; 95% CI 0.84 to 0.86) and systolic BP (AUC=0.79; 95% CI 0.78 to 0.80)). The final cut-off values for the non-invasive method were WHtR ≥0.56 and BP ≥128/80 mm Hg, which includes four levels of MetS risk (very low, low, moderate and high).

Conclusions The analysed method has shown a high validity index (higher than 91%) for the early detection of MetS. It is a non-invasive method that is easy to apply and interpret in any healthcare setting. This method provides a scale of MetS risk which allows more accurate detection and more effective intervention.

  • metabolic syndrome
  • early detection
  • non-invasive method
  • cardiovascular risk
  • working population

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  • Contributors MR-S and contributed tothe conception, design, acquisition and analysis/interpretation of data, and draftedthe manuscript. PT contributed to the data collection and analysis. MV-Acontributed to analysis and interpretation of data. A-AL-G contributed to thedata collection and analysis. F-JF-J contributed to the analysis of data. AA andCA-F contributed to the conception. GM-R contributed to the analysis andinterpretation. MB-V contributed to the design, acquisition andanalysis/interpretation of data. All authors critically revised the manuscript,gave final approval and agree to be accountable for the integrity and accuracyof all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional Review Board of the Mallorca Health Management Ethical Review Committee of GESMA.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Extra data can be accessed via the Dryad data repository at with the doi:10.5061/dryad.cb51t54.

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