Abstract Body (Do not enter title and authors here): Background: Metabolic syndrome (MtS) is a cluster of risk factors, including hypertension, hyperglycemia, abdominal obesity, and dyslipidemia, which increase the risk of cardiovascular disease and poor glycemic control in type 2 diabetes (T2D) patients. Understanding the differences in glycemic profiles, cardiovascular risk factors, and insulin resistance between T2D patients with and without MtS is crucial for developing targeted interventions and identifying key predictors of MtS.
Hypothesis: T2D patients with MtS show poor glycemic control and higher cardiovascular (CV) risk factors than those without MtS.
Aims: This study aimed to compare the glycemic profile, cardiovascular risk factors, and insulin resistance, and identify predictors of metabolic syndrome in patients with T2D.
Methods: Anthropometric and biochemical data of 2923 T2D patients (aged 18 years or older) who participated in a one-year online diabetes management program in India from 2020 to 2022 were examined retrospectively. The diagnosis of Metabolic Syndrome (MtS) was based on the NCEP-ATP III criteria (Triglyceride (TG) ≥150mg/dL, Blood Pressure≥130/85mmHg, and Fasting glucose ≥100mg/dL).
Results: The mean age of the study population was 50±10 years. Among the 2923 patients, 7% had MtS. Patients with Mts displayed significantly higher BMI (27.2 vs. 25.6kg/m2), HbA1c (8.7 vs. 7.4%), fasting glucose (162 vs. 128 mg/dL), and postprandial blood glucose (195 vs.151 mg/dL) compared to those with MtS (p<0.01) Additionally, individuals with T2D and MtS exhibited higher CV risk factors; HDL (39 vs. 41 mg/dL), LDL (119 vs. 99 mg/dL), TG (207 vs.121mg/dL), TG/HDL (5.3 vs.2.9), and blood pressure (140/90 vs.122/80 mmHg) (p<0.01). Moreover, patients with MtS also demonstrated higher insulin resistance calculated by Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (3.9 vs.2.5), high sensitivity C-reactive protein (3.2 vs.1.7 mg/L), and urine microalbumin (11.2 vs.5.9 µg/ml), but lower vitamin D (19 vs. 23 ng/mL) (p< 0.01) than those without MtS. Notably,TG/HDL emerged as a significant predictor of metabolic syndrome (p<0.01).
Conclusion: This study reveals significant differences in glycemic profiles, CV risk factors, and insulin resistance between T2D patients with and without metabolic syndrome, with the TG/HDL ratio identified as a key predictor of metabolic syndrome. This suggests the need for targeted strategies to reduce the risk factors associated with MtS in T2D patients.