{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:26:23Z","timestamp":1781709983916,"version":"3.54.5"},"reference-count":51,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Metabolic syndrome is a significant public health issue, particularly in urbanizing regions like the Peruvian Amazon, where lifestyle changes have increased the prevalence of metabolic disorders. This study aimed to develop and validate a simple, cost-effective diagnostic model for early detection of metabolic syndrome in the urban population of San Juan Bautista, Iquitos. Methods: A cross-sectional study was conducted with 251 adults aged over 18 years. Data collection included anthropometric measurements, body composition analysis, and biochemical assessments. Logistic regression analyses identified key predictors of metabolic syndrome, and clinical decision trees were developed to enhance diagnostic accuracy. Results: The prevalence of metabolic syndrome was 47.9%. Systolic blood pressure, triglycerides, and very-low-density lipoprotein cholesterol were the strongest predictors. The most effective diagnostic model, combining very-low-density lipoprotein cholesterol and systolic blood pressure, achieved a sensitivity of 91.6% and a specificity of 78.5%, demonstrating high diagnostic accuracy. Conclusions: The proposed model offers a practical, low-cost tool for early detection of metabolic syndrome in resource-limited urban settings. However, its findings are limited by the small sample size and the lack of external validation, requiring further studies to confirm its generalizability and applicability to other populations. Its implementation in primary healthcare could facilitate timely interventions, reducing the risk of chronic diseases in vulnerable populations.<\/jats:p>","DOI":"10.3390\/nu17030538","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T09:16:26Z","timestamp":1738314986000},"page":"538","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Metabolic Syndrome in the Amazon: Customizing Diagnostic Methods for Urban Communities"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8949-1907","authenticated-orcid":false,"given":"Jos\u00e9 M.","family":"Alcaide-Leyva","sequence":"first","affiliation":[{"name":"Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain"},{"name":"Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6146-4402","authenticated-orcid":false,"given":"Manuel","family":"Romero-Salda\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain"},{"name":"Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3592-9146","authenticated-orcid":false,"given":"Mar\u00eda","family":"Garc\u00eda-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Nursing and Nutrition, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Calle Tajo S\/N, 28670 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5223-7400","authenticated-orcid":false,"given":"Rafael","family":"Molina-Luque","sequence":"additional","affiliation":[{"name":"Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain"},{"name":"Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4575-790X","authenticated-orcid":false,"given":"Mar\u00eda del Roc\u00edo","family":"Jim\u00e9nez-M\u00e9rida","sequence":"additional","affiliation":[{"name":"Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain"},{"name":"Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0005-4901","authenticated-orcid":false,"given":"Guillermo","family":"Molina-Recio","sequence":"additional","affiliation":[{"name":"Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain"},{"name":"Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1464-5491.2006.01858.x","article-title":"Metabolic Syndrome\u2014A New World-wide Definition. A Consensus Statement from the International Diabetes Federation","volume":"23","author":"Alberti","year":"2006","journal-title":"Diabet. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.jacc.2010.05.034","article-title":"The Metabolic Syndrome and Cardiovascular Risk: A Systematic Review and Meta-Analysis","volume":"56","author":"Mottillo","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.2337\/diab.37.12.1595","article-title":"Role of Insulin Resistance in Human Disease","volume":"37","author":"Reaven","year":"1988","journal-title":"Diabetes"},{"key":"ref_4","first-page":"e38","article-title":"Heart Disease and Stroke Statistics\u20142016 Update: A Report from the American Heart Association","volume":"133","author":"Mozaffarian","year":"2016","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S140","DOI":"10.1111\/j.1753-4887.2004.tb00084.x","article-title":"The Nutrition Transition: An Overview of World Patterns of Change","volume":"62","author":"Popkin","year":"2004","journal-title":"Nutr. Rev."},{"key":"ref_6","unstructured":"Organizaci\u00f3n Panamericana de la Salud (OPS) (2021). Obesity and Overweight in the Americas, Pan American Health Organization."},{"key":"ref_7","unstructured":"Ministerio de Salud del Per\u00fa (MINSA) (2021). Encuesta Demogr\u00e1fica y de Salud Familiar 2021."},{"key":"ref_8","unstructured":"International Diabetes Federation (IDF) (2021). IDF Diabetes Atlas, International Diabetes Federation. [10th ed.]."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1001\/jama.2009.726","article-title":"Diabetes in Asia: Epidemiology, Risk Factors, and Pathophysiology","volume":"301","author":"Chan","year":"2009","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"871S","DOI":"10.1093\/jn\/131.3.871S","article-title":"The Nutrition Transition and Obesity in the Developing World","volume":"131","author":"Popkin","year":"2001","journal-title":"J. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.jclinepi.2007.08.012","article-title":"Indices of Abdominal Obesity Are Better Discriminators of Cardiovascular Risk Factors than BMI: A Meta-Analysis","volume":"61","author":"Lee","year":"2008","journal-title":"J. Clin. Epidemiol."},{"key":"ref_12","first-page":"801","article-title":"BMI Compared with Central Obesity Indicators in an Urban Amazonian Context","volume":"32","author":"Nyamdorj","year":"2021","journal-title":"Int. J. Obes."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the Metabolic Syndrome","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1038\/ijo.2010.135","article-title":"Obesity-Related Non-Communicable Diseases: South Asians vs White Caucasians","volume":"35","author":"Misra","year":"2011","journal-title":"Int. J. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"91","DOI":"10.24841\/fa.v14i2.148","article-title":"Biodiversidad Amaz\u00f3nica y Gastronom\u00eda Regional","volume":"14","author":"Chirif","year":"2005","journal-title":"Folia Amaz."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1017\/S0954422410000144","article-title":"A Systematic Review of Waist-to-Height Ratio as a Screening Tool for the Prediction of Cardiovascular Disease and Diabetes: 0\u00b75 Could Be a Suitable Global Boundary Value","volume":"23","author":"Browning","year":"2010","journal-title":"Nutr. Res. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1038\/ejcn.2009.68","article-title":"Body Mass Index, Waist Circumference and Waist\u2013Hip Ratio as Predictors of Cardiovascular Risk\u2014A Review of the Literature","volume":"64","author":"Huxley","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2817","DOI":"10.1038\/oby.2007.334","article-title":"The Use of BMI and Waist Circumference as Surrogates of Body Fat Differs by Ethnicity","volume":"15","author":"Lear","year":"2007","journal-title":"Obesity"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1089\/met.2009.0024","article-title":"The Metabolic Syndrome in South Asians: Epidemiology, Determinants, and Prevention","volume":"7","author":"Misra","year":"2009","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/ejcn.2009.70","article-title":"Appropriateness of Waist Circumference and Waist-to-Hip Ratio Cutoffs for Different Ethnic Groups","volume":"64","author":"Lear","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1093\/ajcn\/84.2.289","article-title":"Global Nutrition Dynamics: The World Is Shifting Rapidly toward a Diet Linked with Noncommunicable Diseases","volume":"84","author":"Popkin","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1017\/S1368980010003320","article-title":"The Prevalence of Metabolic Syndrome in Latin America: A Systematic Review","volume":"14","author":"Vizmanos","year":"2011","journal-title":"Public Health Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1753-4887.2011.00456.x","article-title":"Global Nutrition Transition and the Pandemic of Obesity in Developing Countries","volume":"70","author":"Popkin","year":"2012","journal-title":"Nutr. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1080\/07399332.2019.1680678","article-title":"The FINDRISC Questionnaire Capacity to Predict Diabetes Mellitus II, Arterial Hypertension and Comorbidity in Women from Low-and-Middle-Income Countries","volume":"41","author":"Leyva","year":"2020","journal-title":"Health Care Women Int."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Alcaide-Leyva, J.M., Romero-Salda\u00f1a, M., Garc\u00eda-Rodr\u00edguez, M., Molina-Luque, R., Jim\u00e9nez-M\u00e9rida, R., and Molina-Recio, G. (2023). Development of a Predictive Model of Cardiovascular Risk in a Male Population from the Peruvian Amazon. J. Clin. Med., 12.","DOI":"10.3390\/jcm12093199"},{"key":"ref_26","first-page":"442","article-title":"A New Lipid Index for Identifying Metabolic Syndrome in the Mexican Population","volume":"19","year":"2008","journal-title":"Eur. J. Intern. Med."},{"key":"ref_27","first-page":"461","article-title":"The TyG Index as a Cardiometabolic Risk Marker in Healthy Young Adults","volume":"53","year":"2016","journal-title":"Acta Diabetol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/S1575-0922(04)74614-8","article-title":"Gu\u00edas Para El Tratamiento de Las Dislipemias En El Adulto: Adult Treatment Panel III (ATP-III)","volume":"51","author":"Rubio","year":"2004","journal-title":"Endocrinol. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.2337\/dc10-1794","article-title":"Measuring Abdominal Obesity: Effects of Height on Distribution of Cardiometabolic Risk Factors Risk Using Waist Circumference and Waist-to-Height Ratio","volume":"34","author":"Schneider","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1467-789X.2011.00952.x","article-title":"Waist-to-height Ratio Is a Better Screening Tool than Waist Circumference and BMI for Adult Cardiometabolic Risk Factors: Systematic Review and Meta-analysis","volume":"13","author":"Ashwell","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/clinchem\/18.6.499","article-title":"Estimation of the Concentration of Low-Density Lipoprotein Cholesterol in Plasma, without Use of the Preparative Ultracentrifuge","volume":"18","author":"Friedewald","year":"1972","journal-title":"Clin. Chem."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Norton, K.I. (2018). Standards for Anthropometry Assessment. Kinanthropometry and Exercise Physiology, Routledge.","DOI":"10.4324\/9781315385662"},{"key":"ref_33","unstructured":"Ladwig, G.B., Ackley, B.J., and Makic, M.B.F. (2021). Mosby\u2019s Guide to Nursing Diagnosis, Revised Reprint with 2021\u20132023 NANDA-I\u00ae Updates-E-Book, Elsevier Health Sciences."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"321","DOI":"10.4067\/S1726-569X2000000200010","article-title":"Declaraci\u00f3n de Helsinki: Principios \u00c9ticos Para La Investigaci\u00f3n M\u00e9dica Sobre Sujetos Humanos","volume":"6","author":"Manzini","year":"2000","journal-title":"Acta Bioethica"},{"key":"ref_35","unstructured":"(2025, January 15). Per\u00fa: Ley No 26.842 de 1997\u2014Ley General de Salud. Available online: https:\/\/www.refworld.org\/es\/leg\/legis\/pleg\/1997\/es\/130591."},{"key":"#cr-split#-ref_36.1","unstructured":"European Union (2016). Reglamento"},{"key":"#cr-split#-ref_36.2","unstructured":"(UE) 2016\/679 del Parlamento Europeo y del Consejo-De 27 de Abril de 2016-Relativo a la Protecci\u00f3n de las Personas F\u00edsicas en lo Que Respecta al Tratamiento de Datos Personales y a la Libre Circulaci\u00f3n de Estos Datos y Por el Que se Deroga la Directiva 95\/46\/CE (Reglamento General de Protecci\u00f3n de Datos), European Union."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"101","DOI":"10.15381\/anales.v73i2.819","article-title":"Prevalencia Del S\u00edndrome Metab\u00f3lico En Pobladores Peruanos Por Debajo de 1 000 y Por Encima de Los 3 000 Msnm","volume":"73","author":"Pajuelo","year":"2012","journal-title":"An. Fac. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11906-018-0812-z","article-title":"The Global Epidemic of the Metabolic Syndrome","volume":"20","author":"Saklayen","year":"2018","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Fran\u00e7a, S.L., Lima, S.S., and Vieira, J.R.D.S. (2016). Metabolic Syndrome and Associated Factors in Adults of the Amazon Region. PLOS ONE, 11.","DOI":"10.1371\/journal.pone.0167320"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1136\/heartjnl-2016-310347","article-title":"Impact of Urbanisation and Altitude on the Incidence of, and Risk Factors for, Hypertension","volume":"103","author":"Gilman","year":"2017","journal-title":"Heart"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"257","DOI":"10.3390\/endocrines4020021","article-title":"Detection of Metabolic Syndrome Using Insulin Resistance Indexes: A Cross-Sectional Observational Cohort Study","volume":"4","author":"Minniti","year":"2023","journal-title":"Endocrines"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"260","DOI":"10.31053\/1853.0605.v79.n3.37313","article-title":"Puntos de Corte de Indicadores Antropom\u00e9tricos Para Hipertensi\u00f3n e Hiperglucemia En Adultos Argentinos","volume":"79","author":"Farinola","year":"2022","journal-title":"Rev. Fac. Cienc. M\u00e9dicas Univ. Nac. C\u00f3rdoba"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1186\/s12933-023-02028-7","article-title":"The Triglyceride-Glucose Index Predicts 1-Year Major Adverse Cardiovascular Events in End-Stage Renal Disease Patients with Coronary Artery Disease","volume":"22","author":"Xie","year":"2023","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Sghaireen, M.G., Al-Smadi, Y., Al-Qerem, A., Srivastava, K.C., Ganji, K.K., Alam, M.K., and Khader, Y. (2022). Machine Learning Approach for Metabolic Syndrome Diagnosis Using Explainable Data-Augmentation-Based Classification. Diagnostics, 12.","DOI":"10.3390\/diagnostics12123117"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"647","DOI":"10.7705\/biomedica.4684","article-title":"Efectividad de Las Intervenciones Para Revertir El Diagn\u00f3stico Del S\u00edndrome Metab\u00f3lico: Actualizaci\u00f3n de Un Metaan\u00e1lisis de Comparaci\u00f3n Mixta de Tratamientos","volume":"39","author":"Navarro","year":"2019","journal-title":"Biom\u00e9dica"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Houser, D.S., Champagne, C.D., and Crocker, D.E. (2013). A Non-Traditional Model of the Metabolic Syndrome: The Adaptive Significance of Insulin Resistance in Fasting-Adapted Seals. Front. Endocrinol., 4.","DOI":"10.3389\/fendo.2013.00164"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Cho, Y., and Lee, S.Y. (2022). Useful Biomarkers of Metabolic Syndrome. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph192215003"},{"key":"ref_48","first-page":"e22848","article-title":"Systematic Review of Metabolic Syndrome Biomarkers: A Panel for Early Detection, Management, and Risk Stratification","volume":"13","author":"Falahi","year":"2015","journal-title":"Int. J. Endocrinol. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Lee, J.H., Lee, K.H., Kim, H.J., Youk, H., and Lee, H.Y. (2022). Effective Prevention and Management Tools for Metabolic Syndrome Based on Digital Health-Based Lifestyle Interventions Using Healthcare Devices. Diagnostics, 12.","DOI":"10.3390\/diagnostics12071730"},{"key":"ref_50","unstructured":"Croci, S., D\u2019Apolito, L.I., Gasperi, V., Catani, M.V., and Savini, I. Dietary Strategies for Management of Metabolic Syndrome: Role of Gut Microbiota Metabolites. Nutrients."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/3\/538\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:24:57Z","timestamp":1760027097000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/3\/538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,31]]},"references-count":51,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["nu17030538"],"URL":"https:\/\/doi.org\/10.3390\/nu17030538","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,31]]}}}