Brief report Novel phenotypic markers and screening score for the metabolic syndrome in adult Asian Indians Anoop Misra a,b, *, Abhishek Jaiswal c , Divya Shakti d , Jasjeet Wasir a,b , Naval Kishor Vikram c , Ravindra Mohan Pandey e , Dimple Kondal e , Bharat Bhushan c a The Department of Diabetes and Metabolic Diseases, Fortis Hospitals, New Delhi, India b The Department of Diabetes and Metabolic Diseases, Fortis Hospitals, Noida, India c The Department of Medicine, All India Institute of Medical Sciences, New Delhi, India d The Johns Hopkins School of Public Health, Baltimore, MD, USA e The Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India 1. Introduction The number of people with the metabolic syndrome (MS) and type 2 diabetes (T2DM) is rapidly increasing in India due to increasing obesity, population growth, and urbanization [1–3]. Insulin resistance is the most important factor in pathogenesis of MS and the consequent T2DM. Prediction of insulin resistance and the MS based on presence of obesity alone would be unreliable [4]. Hyperinsulinemic euglycemic clamp technique, though considered as ‘‘gold standard’’ for measure- ment of insulin resistance [5], is too complicated, lengthy and expensive for routine use, and hence fasting hyperinsulinemia diabetes research and clinical practice 79 (2008) e1–e5 article info Article history: Received 8 January 2007 Accepted 7 August 2007 Published on line 18 September 2007 Keywords: Buffalo hump Diabetes Insulin resistance Asian Indians abstract Aims: The metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM) are common in Asian Indians. Simple yet reliable phenotypic markers are needed for early detection of the MS in Asian Indians. Methods: In this cross-sectional study, 126 subjects either with of without the MS were compared. Anthropometric measurements (including assessment of novel phenotypic markers) and metabolic profile were done. Results: On univariate analysis, age more than 35 year, female gender, presence of buffalo hump and double chin and family history of T2DM were significantly associated with the MS. A metabolic syndrome screening (MSS) score (1.0  double chin + 1.2  buffalo hump + 1.3  gender + 1.4  age category) was generated with a cutoff value of 3.5 out of total points of 4.9, with sensitivity and specificity 82% and 71% [area under the curve = 0.83; 95% confidence Interval (0.76–0.90)], respectively in detecting individuals with the MS. Conclusion: We describe buffalo hump and double chin as novel phenotypic markers for detection of MS for the first time. The MSS score generated by us may be a useful tool for detection of MS in adult Asian Indians; however, it needs further validation in a larger sample of Asian Indians and in other ethnic groups. # 2007 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: The Department of Diabetes and Metabolic Diseases, Fortis Hospitals, New Delhi, India. Tel.: +91 11 4277 6222; fax: +91 11 4277 6221. E-mail address: anoopmisra@metabolicresearchindia.com (A. Misra). available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/diabres 0168-8227/$ – see front matter # 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.diabres.2007.08.002