Predictors of metabolic syndrome among type II diabetic patients visiting public hospitals in Sidama Region, Ethiopia: unmatched case control study

INTRODUCTION: Metabolic syndrome (MetS) is a series of health conditions, including insulin resistance, abdominal obesity, hypertension, and dyslipidemia. In diabetic patients, MetS elevates the risks of cardiovascular disease, stroke, and cardiovascular mortality. Its predictors are context-dependent, varying by diagnostic criteria and population characteristics, thus requiring localized studies to identify specific determinant factors. OBJECTIVE: To assess predictors of MetS among type II diabetic patients (T2DM) visiting public hospitals in Sidama Region, Ethiopia, from January 25- March 25, 2025. METHODS: An institutional unmatched case control study design was employed among 132 cases and 268 controls. Data were collected using a structured, interviewer-administered questionnaire adapted from the World Health Organization (WHO) STEPS instrument, complemented by laboratory investigations and standardized anthropometric measurements. MetS was diagnosed using the International Diabetes Federation (IDF) criteria. Bivariable and multivariable logistic regression models were fitted to determine predictors of MetS. Results were presented using adjusted odds ratios (AOR) with 95% confidence intervals (CI). RESULT: The mean age (± standard deviation) of the cases and controls was 56.9 (± 8.2) and 49.5 (± 8.1) years, respectively. MetS was found to be higher in female (61.4%) study participants than in male (38.6%). The identified predictors of MetS with 95% CI (AOR) were older age: 5.74 (2.56, 12.88), female sex: 2.91 (1.61, 5.26), urban residence: 2.59 (1.41, 4.75), monthly income > 3500 Ethiopian Birr: 4.30 (2.23, 8.28), family history of hypertension: 2.79 (1.47, 5.29), duration with DM: 5-9 years: 3.06 (1.57, 5.99) and ≥ 10 years: 3.61 (1.54, 8.48), and poor glycemic control: 3.93 (2.17, 7.13). CONCLUSION: The findings call for prioritizing targeted screening, lifestyle interventions, health education, and community-based programs to enhance the prevention, early detection, and management of MetS among T2DM patients.