Background: Background: Metabolic syndrome (MetS) is a cluster of risk factors, including abdominal obesity, dyslipidemia, hyperglycemia and hypertension that markedly elevate the incidence of cardiovascular diseases and type 2 diabetes.
Objective: This study aimed to evaluate the diagnostic value of serum angiopoietin-like protein 4 (ANGPTL4) and Caveolin-1 (Cav-1), as novel agents in diagnosing MetS in patients older than 50 years.
Methods: A case-control study (January–April 2025) included 60 cases with MetS and 30 matched-healthy participants of the same gender and age (>50 years) from hospitals in Diyala Governorate, Iraq. MetS was diagnosed by harmonized definition (≥3 features: elevated waist diameter, triglyceride ≥150 mg/dL, low HDL-C, BP ≥130/85 mmHg and fasting glucose ≥100 mg/dL).
Results: Serum ANGPTL4 (142.78 ± 22.53 vs. 69.29 ± 30.80 ng/mL, p-value <0.001) and Cav-1 (16.12 ± 2.87 vs. 8.51 ± 1.59 ng/mL, p-value <0.001) were significantly elevated in the MetS group. Receiver Operating Characteristic (ROC) analysis demonstrated exceptional diagnostic performance, with an Area Under the Curve (AUC) of 0.97 for ANGPTL4 and 0.99 for Cav-1. Binary logistic regression analysis identified both biomarkers as significant independent predictors of MetS. Conclusion: Serum ANGPTL4 and Caveolin-1 levels exhibited outstanding diagnostic performance for MetS in Iraqi adults aged >50 years, reflecting underlying lipid dysregulation and endothelial dysfunction. These biomarkers showed significant potential for enhancing early detection and clinical management, warranting validation in a broader population.