Association of Metabolic Syndrome with Early Renal Dysfunction in Patients with Type 2 Diabetes Mellitus: A Hospital-Based Cross-Sectional Study

Abstract

Objective: To determine the association between metabolic syndrome and early renal dysfunction among patients with type 2 diabetes mellitus attending a tertiary-care hospital in Pakistan. Methodology: This Cross-sectional study was conducted at Bakhtawar Amin Hospital in Multan from January 2024 to December 2025. We enrolled 204 adults with type 2 diabetes using consecutive sampling. Metabolic syndrome was diagnosed using harmonized criteria. We defined early renal dysfunction as a urinary albumin-to-creatinine ratio of 30–300 mg/g and/or an estimated glomerular filtration rate of 60–89 mL/min/1.73 m². We excluded patients with established chronic kidney disease, acute kidney injury, or non-diabetic renal disease. We used multivariable logistic regression to identify factors independently associated with early renal dysfunction. Results: The mean age was 52.6±9.8 years, and 112 (54.9%) participants were women. Metabolic syndrome was present in 142 (69.6%) patients, while early renal dysfunction was detected in 78 (38.2%). Renal dysfunction was more common among patients with metabolic syndrome than among those without it (45.8% versus 21.0%; p<0.001). Metabolic syndrome remained independently associated with early renal dysfunction after adjustment for relevant variables (adjusted odds ratio 2.54; 95% confidence interval 1.23–5.24). Longer diabetes duration, hypertension, and poor glycemic control were also independent predictors. Conclusion: Metabolic syndrome was common and was independently associated with early renal dysfunction. Affordable metabolic and renal screening should be incorporated into routine diabetes care.