Anthropometric Indices as Predictors of Metabolic Syndrome in Indonesian Adults: A Comparison of BRI, C- Index, and Traditional Anthropometric Measures

Background Obesity is strongly linked to insulin resistance, and both conditions underlie the pathophysiology of Metabolic Syndrome (MetS). Anthropometric measurements to identify body fat are useful when screening individuals at risk for MetS. Objectives This study aims to compare the diagnostic ability of the body roundness index (BRI), conicity index (C-index), body mass index (BMI), and waist-to-height ratio (WHtR) as MetS predictors among Indonesian adults. Methods This cross-sectional study used secondary data from the Baseline Health Research of 2018 (Riskesdas 2018). A total of 13,792 adults aged ≥ 19 years (4,655 men and 9,137 women) with complete data on anthropometric measurements, blood pressure, lipid profile, and fasting blood glucose were analyzed using descriptive analysis and area under the curve (AUC) comparisons to determine the diagnostic ability of anthropometric parameters as predictors of MetS. Results The four anthropometric parameters demonstrated moderate to good predictive ability to predict MetS (AUC = 0.7–0.9). WHtR and BRI (AUC _men = 0.800; AUC _female = 0.802) were significantly better predictors than the other anthropometric parameters in women but were not significantly different from BMI (AUC = 0.794) in men. Conversely, the C-index (AUC _men = 0.742; AUC _female = 0.710) was significantly less predictive than the other parameters. Conclusions BRI and WHtR demonstrated good and comparable performance in detecting MetS. In women, both were superior to BMI and the C-index, while in men, their performance was similar to BMI. The C-index showed the weakest predictive power. The recommended cut-off values for MetS screening are WHtR ≥ 0.51 (men) and ≥ 0.53 (women).