Screening accuracy of Single-Point Insulin Sensitivity Estimator (SPISE) for metabolic syndrome: a systematic review and meta-analysis.

Abstract

Background: Metabolic syndrome (MetS) is a multifactorial condition linked to increased risk of cardiovascular disease and type 2 diabetes. The Single-Point Insulin Sensitivity Estimator (SPISE), a non-invasive index calculated via 600 × HDL-C^0.185 / (TG^0.2 × BMI^1.338), offers a practical alternative. This systematic review and meta-analysis aim to evaluate the accuracy of SPISE as an indicator for MetS.

Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines. We searched databases such as MEDLINE, Scopus, Web of Science, and Embase, focusing on studies evaluating SPISE's screening accuracy for MetS. Eligible studies were observational, reporting mean SPISE values and its predictive performance. Meta-analyses were performed using Hedges' g standardized mean differences (SMD) and pooled area under the curve (AUC) estimates.

Results: Seven studies comprising 12,919 participants were included, with an age range of 9.2 ± 2.1 to 52.4 ± 11.0. Individuals with MetS had significantly lower SPISE scores than controls (SMD = -0.94, 95% CI: -1.25 to -0.63). The pooled AUC for SPISE as a predictor of MetS was 0.86 (95% CI: 0.83 to 0.90), surpassing other insulin resistance indices like HOMA-IR and the triglyceride/HDL-C ratio. Meta-regression showed that systolic and diastolic blood pressure were potential sources of heterogeneity and age, gender, BMI, waist circumference, fasting blood glucose, triglyceride, and HDL did not contribute to heterogeneity.

Conclusions: SPISE is a highly accurate and non-invasive tool for predicting MetS, potentially outperforming traditional indices like HOMA-IR. Its ease of use and precision make it a valuable clinical screening tool, especially in diverse populations.