New Biomarkers for Predicting Systemic Complications in Obesity

November 21, 2025 updated by: Elif Azize Özşahin Delibaş, Tokat Gaziosmanpasa University

Assessment of Anthropometric and Biochemical Indices in Predicting Metabolic Syndrome Across Obesity Classes

This observational cross-sectional study classified participants into obesity classes (Class I: BMI 30.0-34.9, Class II: 35.0-39.9, Class III: ≥40.0 kg/m²) based on WHO criteria. Anthropometric and biochemical measurements were used to calculate a wide range of obesity-related and cardiometabolic risk indices. The aim was to analyze whether these indices could effectively predict the presence of Metabolic Syndrome (MetS), as defined by the NCEP-ATP III criteria.

Study Overview

Status

Completed

Conditions

Detailed Description

In this study, a comprehensive set of anthropometric, biochemical, and derived indices was utilized to assess the relationship between obesity and Metabolic Syndrome (MetS) beyond the scope of traditional measures. While Body Mass Index (BMI) served as the primary criterion for general obesity classification, it was complemented by additional indices that are considered more reflective of fat distribution and visceral adiposity. These included the Visceral Adiposity Index (VAI), Waist-to-Height Ratio (WHtR), Waist-to-Hip Ratio (WHpR), Body Adiposity Index (BAI), and Conicity Index (COI), all of which provide greater specificity in evaluating central obesity-a key factor in cardiometabolic risk.

To capture the metabolic dimension of obesity, biochemical indices such as the Triglyceride-Glucose (TyG) index were calculated, as this marker has been shown to correlate strongly with early insulin resistance and glucose homeostasis disruption. Additionally, the Lipid Accumulation Product (LAP), which combines waist circumference and triglyceride levels, was employed to estimate the extent of visceral fat accumulation and its associated metabolic burden.

To further investigate cardiovascular and atherogenic risk, several lipid-based indices were assessed, including the Atherogenic Coefficient (AC), Atherogenic Plasma Index (API), the Triglyceride-to-HDL cholesterol (TG/HDL) ratio, non-HDL cholesterol, and the Cholindex. The inclusion of these diverse indices allowed for a more nuanced and multidimensional evaluation of the associations between obesity phenotypes and MetS status, with the aim of identifying reliable predictors beyond conventional clinical parameters.

Study Type

Observational

Enrollment (Actual)

332

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Tokat Province, Turkey (Türkiye), 60250
        • Tokat Gaziosmanpaşa University Health Research and Application Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Obese adult individuals (BMI ≥30 kg/m²) aged 18-65 years who presented voluntarily to an internal medicine outpatient clinic were included in the study. Participants had no known chronic diseases, were not pregnant or breastfeeding, and were not receiving hormone therapy or lipid-lowering treatment. Individuals with cardiovascular disease, thyroid dysfunction, polycystic ovary syndrome, malignancy, inflammatory disease, acute infection, or other metabolic disorders were excluded.

Description

Inclusion Criteria:

  • Being diagnosed with obesity
  • Being between the ages of 18 and 65

Exclusion Criteria:

  • Having any other chronic disease (cardiovascular disease, polycystic ovary syndrome, thyroid dysfunction, asthma, etc.)
  • Receiving hormone therapy
  • Taking lipid-lowering medication
  • Being pregnant/breastfeeding
  • Having an acute infection
  • Having a malignant or inflammatory disease

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Body Mass Index (BMI) was used to classify levels of obesity.
Time Frame: Directly taken by trained staff during face-to-face assessments.
BMI is an anthropometric parameter obtained by dividing body weight in kilograms by the square of height in metres (kg/m²). According to the World Health Organization (WHO) classification, individuals with a BMI of less than 18.5 kg/m² are underweight; those with a BMI between 18.5 and 24.9 kg/m² are of normal weight; those with a BMI between 25.0 and 29.9 kg/m² are overweight (pre-obese); and those with a BMI between 30.0 and 34.9 kg/m² are classified as class 1 obese (moderate); those between 35.0-39.9 kg/m² are class 2 obese (severe); and those ≥40.0 kg/m² are class 3 obese (morbid)
Directly taken by trained staff during face-to-face assessments.
MetS was diagnosed according to National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III) criteria.
Time Frame: Anthropometric measurements were directly taken by trained staff during face-to-face assessments. Biochemical data were retrospectively obtained from hospital medical records.
Five clinical parameters were evaluated accordingly: WC, FBG, HDLc, TG level and blood pressure. The following were accepted as components of MetS: WC≥102 cm in men and ≥88 cm in women; TG level ≥150 mg/dL; HDLc level <40 mg/dL in men and <50 mg/dL in women; blood pressure ≥130/85 mmHg; and FBG level ≥100 mg/dL. Individuals were classified as MetS (+) if at least three of the five specified parameters met the diagnostic criteria and as MetS (-) if they did not.
Anthropometric measurements were directly taken by trained staff during face-to-face assessments. Biochemical data were retrospectively obtained from hospital medical records.
Waist-to-Height Ratio
Time Frame: Directly taken by trained staff during face-to-face assessments.
Waist Circumference (cm) / Height (cm)
Directly taken by trained staff during face-to-face assessments.
Waist-to-Hip Ratio
Time Frame: Directly taken by trained staff during face-to-face assessments.
Waist Circumference (cm) / Hip Circumference (cm)
Directly taken by trained staff during face-to-face assessments.
Lipid Accumulation Product
Time Frame: Anthropometric measurements were directly taken by trained staff during face-to-face assessments. Biochemical data were retrospectively obtained from hospital medical records.
For men: [WC (cm) - 65] × TG (mmol/L) For women: [WC (cm) - 58] × TG (mmol/L)
Anthropometric measurements were directly taken by trained staff during face-to-face assessments. Biochemical data were retrospectively obtained from hospital medical records.
Visceral Adiposity Index
Time Frame: Anthropometric measurements were directly taken by trained staff during face-to-face assessments. Biochemical data were retrospectively obtained from hospital medical records.
For men: [WC (cm) / (39.68 + (1.88 × BMI))] × (TG / 1.03) × (1.31 / HDLc) For women: [WC (cm) / (36.58 + (1.89 × BMI))] × (TG / 0.81) × (1.52 / HDLc)
Anthropometric measurements were directly taken by trained staff during face-to-face assessments. Biochemical data were retrospectively obtained from hospital medical records.
Conicity Index
Time Frame: Directly taken by trained staff during face-to-face assessments.
WC (m) / [0.109 × √(Weight (kg) / Height (m))]
Directly taken by trained staff during face-to-face assessments.
Body Adiposity Index
Time Frame: Directly taken by trained staff during face-to-face assessments.
(Hip Circumference (cm) / [Height (m)]¹·⁵) - 18
Directly taken by trained staff during face-to-face assessments.
Atherogenic Coefficient
Time Frame: Biochemical data were retrospectively obtained from hospital medical records.
(Total Cholesterol - HDLc) / HDLc
Biochemical data were retrospectively obtained from hospital medical records.
Atherogenic Index of Plasma
Time Frame: Biochemical data were retrospectively obtained from hospital medical records.
log10 (TG / HDLc)
Biochemical data were retrospectively obtained from hospital medical records.
TG/HDLc multiplied by Waist-to-Height Ratio combine index
Time Frame: Anthropometric measurements were directly taken by trained staff during face-to-face assessments. Biochemical data were retrospectively obtained from hospital medical records.
(TG / HDLc) × WhtR
Anthropometric measurements were directly taken by trained staff during face-to-face assessments. Biochemical data were retrospectively obtained from hospital medical records.
Triglyceride-Glucose Index
Time Frame: Biochemical data were retrospectively obtained from hospital medical records.
ln [TG (mg/dL) × Fasting Glucose (mg/dL) / 2]
Biochemical data were retrospectively obtained from hospital medical records.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Tokat Gaziosmanpasa University

Investigators

  • Principal Investigator: Elif A Özşahin Delibaş, Asst. Prof., Tokat Gaziosmanpaşa University, Faculty of Health Sciences, Department of Nutrition and Dietetics
  • Study Chair: Emre Y Kuyucu, Lecturer, Tokat Gaziosmanpaşa Üniversity, Faculty of Medicine, Department of Biostatistics

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2025

Primary Completion (Actual)

May 30, 2025

Study Completion (Actual)

August 30, 2025

Study Registration Dates

First Submitted

November 21, 2025

First Submitted That Met QC Criteria

November 21, 2025

First Posted (Estimated)

December 3, 2025

Study Record Updates

Last Update Posted (Estimated)

December 3, 2025

Last Update Submitted That Met QC Criteria

November 21, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 24-KAEK-008

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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