LAUSR

1Department of Metabolism and Endocrinology, The First Affiliated Hospital of University of South China, Hengyang, 421001, Hunan Province, People’s Republic of China; 2Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of University of South China, Hengyang, 421001, Hunan Province, People’s Republic of China Metabolic syndrome (MS) refers to the metabolic disorders of proteins, fat and carbohydrates that represent risk factors for cardiovascular disease, diabetes and cancer. The prevalence of MS is increasing worldwide due to deteriorating lifestyles, current statistic estimates suggest that one-quarter of the global population, more than 1 billion people, has MS. Prevention of MS is an important public health objective as it will reduce of the future societal burden of diabetes and cardiovascular disease. Recently, novel metabolic indices combining both anthropometric and lipid measures were coming out as estimators of visceral adiposity dysfunction and lipid overaccumulation. These new indices, including visceral adiposity index (VAI), lipid accumulation product (LAP) and the product of triacylglycerol and glucose (TyG), have been suggested as early markers of insulin resistance. Researchers have highlighted that these new indices are more sensitive indicator of diabetes compared to the traditional adiposity markers (such as BMI and WC), although it remains disputed due to the difference between diverse regions. Additional, TyG is a novel candidate to predict chronic kidney diseases, while LAP index reported to show the highest ability to predict insulin resistance and subclinical vascular damage. Accumulating evidence also has suggested that the three parameters have been regarded as simple and novel clinical markers of MS, but they are all cross-sectional. Hence, a comprehensive consensus has not been reached about the best indices for evaluating the status and risk of MS. It is important to find simple and reliable indicators for easy prediction of patients with MS in clinical settings. We therefore studied the associations of different novel metabolic indices with incident MS among women and men from the population-based study. The study was a retrospective cohort study carried out in Hengyang, a district of Hunan, China, which was part of the China National Stroke Screening and Prevention Project (CNSSPP). A total of 4008 subjects, aged over 40 years, were enrolled by cluster sampling at baseline 2013, and follow-up examinations 2019. On both occasions, all participants were assessed using a structured interview (including demographic characteristics, behavioral risk factors, medical history), clinical and anthropometric measurements, and biochemical and serological test. Notably, for persons who failed to participate punctually, we took measures by telephone counseling and home visits to reduce the loss of participants in the follow-up survey. In addition, the death outcome Correspondence: Jiang-Hua Liu; Xin-Hua Xiao Email [email protected]; [email protected]