The aim of this study was to explore the association of the triglyceride to high-density lipoprotein ratio (TG/HDL) and the visceral adiposity index (VAI) with metabolic syndrome (Mets) in high-risk populations of diabetic patients. Patients were recruited from the Endocrinology Clinic of Hebei General Hospital from April 2018 to April 2019,according to the "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2017 Edition)". A total of 824 patients participated in the study. The association between TG/HDL or VAI and Mets in these patients was assessed using a multivariate logistic regression model. Receiver operating characteristic (ROC) curve analysis was used to evaluate the ability of TG/HDL and VAI to predict Mets in the diabetic susceptible population. The prevalence of Mets gradually increased in males and females with advancing tertiles of TG/HDL or VAI. After adjusting for the relevant risk factors, TG/HDL and VAI were positively correlated with Mets in men and women. Both of them showed a better the area under the ROC curve (AUC) for Mets in females than body mass index, waist circumference, TG and homeostatic model assessment of insulin resistance. In females, the cut-off point of 1.67 for VAI showed a higher accuracy for Mets (sensitivity 0.756, specificity 0.705, Youden index 0.461), the same relationship not significant in men. TG/HDL and VAI provide a high predictive value for Mets in a diabetic susceptible population, especially in females.
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