Journal Article

The Interplay of Cardiometabolic Syndrome Phenotypes and Cardiovascular Risk Indices in Patients Diagnosed with Diabetes Mellitus

Vladu, Ionela Mihaela, Assani, Mohamed-Zakaria, Mitrea, Adina, Clenciu, Diana, Boldeanu, Mihail Virgil, Siloși, Isabela, Ciobanu, Daniela, Boldeanu, Lidia, Mitroi Sakizlian, Daniela Denisa, Ciobanu Plasiciuc, Alina Elena, Șarla, Andra Veronica

2025

Overview

Metabolic syndrome (MetS) and its associated cardiometabolic phenotypes significantly contribute to the global burden of cardiovascular disease (CVD), especially in individuals with type 2 diabetes mellitus (T2DM) and prediabetes. This study aimed to explore the association between cardiometabolic phenotypes—specifically, metabolically unhealthy normal weight (MUHNW) and metabolically unhealthy obese (MUHO)—and various cardiovascular risk indices including the triglyceride-glucose (TyG) index and its derivatives, the atherogenic index of plasma (AIP), the cardiometabolic index (CMI), and the cardiac risk ratio (CRR). A total of 300 participants were evaluated (100 with prediabetes and 200 with T2DM). Anthropometric, biochemical, and lifestyle parameters were assessed and stratified across phenotypes. The results demonstrated that cardiovascular risk indices were significantly elevated in the MUHO compared to MUHNW phenotypes, with T2DM patients consistently exhibiting higher risk profiles than their prediabetic counterparts. TyG-derived indices showed strong correlations with BMI, waist–hip ratio (WHR), waist–height ratio (WHtR), and body fat percentage (%BF). The findings suggest that cardiometabolic phenotypes are more strongly associated with elevated cardiometabolic risk indices than body weight alone. These indices may enhance early risk stratification and intervention efforts. The study investigates the association of cardiometabolic phenotypes with surrogate cardiovascular risk indices, not direct CVD outcomes, However, the cross-sectional design and population homogeneity limit the generalizability of the results and preclude causal inference.

• Publisher: MDPI AG
• Subject: Adult / Aged / Anthropometry / Biomarkers / Blood Glucose / Blood pressure / Body Mass Index / Body weight / Cardiac patients / Cardiometabolic Risk Factors / Cardiovascular diseases / Cardiovascular Diseases - etiology / Cholesterol / Cross-Sectional Studies / Diabetes / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - metabolism / Enzymes / Female / Genetic aspects / Glucose / Health aspects / Health care / Heart Disease Risk Factors / Humans / Hypertension / Lipids / Male / Medical history / Metabolic disorders / Metabolic syndrome / Metabolic Syndrome - complications / Metabolic Syndrome - metabolism / Middle Aged / Mortality / Obesity / Obesity - complications / Pathophysiology / Phenotype / Prediabetic state / Prediabetic State - complications / Public health / Risk assessment / Risk Factors / Statistical analysis / Triglycerides - blood / Type 2 diabetes / Waist-Hip Ratio