Immunometabolic Score AISI, UHR, RDW-to-Triglycerides and LDL-c-to-HDL-c Ratios as Early Markers of Cardiometabolic Risk in a Young Mexican Population with Elevated Waist-to-Height Ratio

BACKGROUND: Obesity is defined as the accumulation of dysfunctional adipose tissue, accompanied by metabolic and immunological disturbances that increase the risk of organ damage. Current definitions recommend the waist-to-height ratio (WHtR) as a practical indicator of central adiposity, while immunometabolic biomarkers may improve early risk stratification. The present study evaluated whether immunometabolic indices derived from routine hematological and lipid parameters can differentiate WHtR categories and identify young adults with elevated cardiometabolic risk. METHODS: A cross-sectional study was conducted with 1296 volunteers aged 18-26 years, from the university health center at the Autonomous University of San Luis Potosi, Mexico. Participants were classified according to WHtR as WHtR < 0.5, WHtR 0.50-0.59, and WHtR ≥ 0.60. The indices calculated were low-density lipoprotein cholesterol (LDL-c)/high-density lipoprotein cholesterol (HDL-c), red cell distribution width (RDW)/HDL-c, RDW/TAG, uric acid-to-HDL-c ratio (UHR), monocyte-to-HDL-c ratio (MHR), and aggregate index of systemic inflammation (AISI). Multivariate analyses were used for exploration, variable selection, and construction of an immunometabolic score. RESULTS: Participants with WHtR ≥ 0.60 represented 10.9% of the cohort and demonstrated higher triglycerides, LDL-c, uric acid, UHR, and MHR, which showed positive correlations with body mass index and blood pressure. UHR demonstrated 85.1% sensitivity and 65.5% specificity in discriminating WHtR ≥ 0.60. A least absolute shrinkage and selection operator-derived immunometabolic score, incorporating LDL-c-to-HDL-c, RDW-to-TAG, UHR, AISI, and sex, increased across WHtR categories and discriminated WHtR ≥ 0.60 with an area under the curve of 0.869. CONCLUSION: These findings support the potential use of these immunometabolic indices as complementary tools for identifying young adults with a higher cardiometabolic risk profile and high central adiposity.