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Background Metabolic syndrome (MetS) and prediabetes (preDM) have crosslinked pathophysiologies with central obesity and insulin resistance (IR). This study aimed to compare and correlate nesfatin and lipopolysaccharide binding protein (LBP) plasma levels, adiposity, atherogenicity and hematological indices between non-diabetic MetS, newly diagnosed drug naive pre-diabetic MetS patients vs. normoglycemic lean controls. Materials and methods In a cross-sectional study, 29 apparently healthy controls, 29 non-diabetic MetS subjects and 30 preDM-MetS patients were recruited. Results The LBP level (ng/mL) was substantially higher in both MetS (non- and pre-diabetic) groups compared to healthy controls. In contrast, circulating level of nesfatin (pg/mL) was lower, though not significantly; in both pre-diabetic and non-diabetic MetS patients compared to lean normoglycemic controls. No correlation was found between nesfatin and LBP in MetS pool (n = 59). Remarkably unlike blood indices; adiposity indices [body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height (WHtR) ratio, hip circumference (HC), body adiposity index (BAI), visceral adiposity index (VAI), lipid accumulation product (LAP) but not conicity index (CI)], atherogenicity indices [(atherogenicity index of plasma (AIP = Log10(TG/HDL-C ratio)), low density lipoprotein cholesterol to high density lipoprotein cholesterol ratio (LDL-C/HDL-C) and non-high density lipoprotein cholesterol (non-HDL-C)] were substantially higher in both MetS (non- and pre-diabetic) groups vs. those of controls. Exceptionally pronounced and proportional nesfatin-DBP and LBP-BAI correlations were identified in total MetS pool (both non-diabetic and pre-diabetic). Conclusions Nesfatin and LBP can be potential targets and surrogate biomarkers to use as putative prognostic/predictive tools for the prevention and treatment for MetS and related disorders.

Cross-sectional correlates of nesfatin and lipopolysaccharide binding protein in metabolic syndrome patients with and without prediabetes