Prevalence and predictors of metabolic syndrome among type 2 diabetes patients: A cross-sectional study in Eastern Cape, South Africa

Background: Metabolic syndrome is a burgeoning global concern that predisposes individuals to cardiovascular diseases and shares a complex bidirectional relationship with type 2 diabetes mellitus (T2DM). Its prevalence and associated risk factors among T2DM patients vary across populations depending on diagnostic criteria. Aim: This study aimed to determine the prevalence, components and predictors of metabolic syndrome among T2DM patients. Setting: The medical outpatient department of Nelson Mandela Academic Hospital, Mthatha, Eastern Cape province, South Africa. Methods: A cross-sectional study was conducted among 142 patients with T2DM. Data on demographic, anthropometric, haemodynamic and biochemical parameters were collected using a structured questionnaire. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Variable-specific standardised descriptive and inferential statistics were computed using SPSS 29. Results: The prevalence of metabolic syndrome was 83.8%, with high rates among females (90.3%). Among males, hypertension (84.2%) and low high-density lipoprotein cholesterol (88.6%) were the most common components, whereas females exhibited higher rates of abdominal obesity (98.1%), hypertriglyceridaemia (83.3%) and dyslipidaemia (84.2%). Abdominal obesity was the predominant risk component (129 [90.8%]). Poor glycaemic control was evident with 111 (83.5%) participants having a glycosylated haemoglobin of 7% or higher. Predictors of metabolic syndrome were obesity in males (odds ratio [OR]: 28.34, 95% confidence interval [CI]: 2.23–359.80, p = 0.010) and dyslipidaemia in females (OR: 59.06, 95% CI: 3.46–1007.16, p = 0.005). Conclusion: Metabolic syndrome was highly prevalent, with abdominal obesity as the predominant risk component. Obesity and dyslipidaemia were significant predictors, and diabetes remained poorly controlled in a large proportion of patients. Contribution: This study is the first to report on the prevalence, main risk components and predictors of metabolic syndrome among T2DM patients in a typical rural South African population.