Soluble P-Selectin and Platelet Indices in Metabolic Syndrome: A Cross-Sectional Study of Associations with Atherogenic and Metabolic Parameters

Introduction: Metabolic syndrome (MetS) comprises central obesity, dyslipidaemia, hypertension, and insulin resistance, and carries increased atherothrombotic risk. Soluble P-selectin (sP-selectin), a platelet activation marker, may contribute to vascular complications. This study compared sP-selectin and platelet indices in MetS patients versus controls and examined associations with lipid, atherogenic, and clinical parameters Methods: A cross-sectional study of 100 participants (50 MetS, 50 controls). Fasting venous blood was analysed for sP-selectin, lipid profile, and platelet indices. Analyses included correlation with false discovery rate correction, hierarchical multiple linear regression, trend analysis, and receiver operating characteristic analysis. Results: sP-selectin was higher in MetS than controls (100.0 ± 16.1 vs 58.0 ± 12.1 ng/mL; P < 0.001). MetS participants also had elevated triglycerides, total cholesterol, LDL-C, non-HDL-C, mean platelet volume (MPV), and platelet distribution width, and lower HDL-C. In MetS, sP-selectin correlated positively with atherogenic index of plasma (AIP) and TyG index; both remained significant after FDR correction (q = 0.046). In hierarchical regression, AIP (standardised β = 0.48; P < 0.001), BMI (β = 0.38; P = 0.004), and MPV (β = 0.36; P = 0.004) were independently associated with sP-selectin. sP-selectin increased with MetS component burden and across AIP tertiles. Conclusion: Patients with MetS showed elevated sP-selectin and adverse lipid and platelet profiles. AIP was most consistently associated with sP-selectin; BMI and MPV were independently associated in the final model. These findings suggest sP-selectin may link atherogenic dyslipidaemia to platelet activation in MetS, but longitudinal studies are needed to establish temporal relationships.