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Mahmoud MA Abulmeaty,1,2 Ghadeer S Aljuraiban,1 Thuraya A Alaidarous,3 Noura M Alkahtani4 1Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 2Medical Physiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 3Clinical Nutrition Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 4Department of Endocrinology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaCorrespondence: Mahmoud MA AbulmeatyDepartment of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi ArabiaTel +966 548155983Fax +966 114693715Email dr.abulmeaty@gmail.comPurpose: Data about body compositional changes throughout the course of type 2 diabetes (T2D) are limited and inconsistent. We investigated the roles of the disease duration and glycemic control in T2D-associated changes of body composition and the components of metabolic syndrome (MetS).Patients and Methods: A total of 25 non-diabetic controls and 92 individuals aged 20– 60 years with T2D were included in a case–control study conducted at King Faisal Specialist Hospital, Saudi Arabia. Based on disease duration (newly diagnosed: within the first year and long duration: ≥ 5 years) and glycemic control (glycated hemoglobin [HbA1C] level ≤ 7%), the patients were divided into the following groups: newly diagnosed and controlled (N&C, n=25), newly diagnosed and uncontrolled (N&U, n=17), old and controlled (O&C, n=25), and old and uncontrolled (O&U, n=25). Blood samples were collected to assess fasting blood glucose level, HbA1C level, and lipid profile. Anthropometric data were evaluated, and body composition was assessed using a bio-impedancemetry analyzer. Nonparametric tests and multivariable logistic regression analyses were performed.Results: Compared to the control group, the fat mass (FM) was significantly higher in all groups; furthermore, the fat mass/fat-free mass (FM/FFM) ratio was significantly higher in the N&C. The N&U and O&U groups showed significantly higher percentages of all components of MetS. Among all selected independent factors, only age increased the likelihood of MetS diagnosis by 7% (OR: 1.07; 95% CI: 1.004– 1.149; P< 0.05). Besides, age, gender, adherence to diet regimen, and T2D duration showed lower odds of increased FM/FFM ratio.Conclusion: This study provided evidence about the impact of T2D on body composition and the other components of MetS. Thus, further characterization of T2D contributes to defining the etiology of the disease to detect and treat poor cardiometabolic health.Keywords: type 2 diabetes, metabolic syndrome, disease duration, HbA1C, FM/FFM ratio, HOMA-IR