BACKGROUNDMetabolic syndrome (MetS) is defined as a metabolic dysfunction characterized by the co-occurrence of multiple risk factors. Our study aimed to elucidate the effects of ADIPOQ rs266729, rs17300539, and rs2241766, AGT rs699 and rs4762, AGTR1 rs5186, AGTR2 rs11091046, ApoC-III rs2854116 and rs2854117, NR3C1 rs10052957 and rs41423247, and GNB3 rs5443 gene polymorphisms on MetS.METHODS AND RESULTSA total of 200 patients who met the diagnostic criteria for MetS at the Internal Medicine Outpatient Clinic of Istanbul University, Faculty of Medicine, between 01.08.2022 and 20.05.2023, and 100 healthy controls were included in our study. ADIPOQ rs17300539 GA, AGT rs699 TT, AGTR1 rs5186 AC, and AGTR2 rs11091046 CC genotypes were more frequently observed in patients diagnosed with MetS compared to healthy controls (p < 0.05 for all). MetS patients with AGT rs699 TT genotype had a higher incidence of hypertension compared to individuals with CC/CT genotype of the same polymorphism (p = 0.047). Individuals with ADIPOQ rs17300539 AA/AG and NR3C1 rs41423247 CC genotypes were found to have higher mean waist circumferences compared to others (p < 0.05 for all). Individuals with ADIPOQ rs17300539 AA/AG, NR3C1 rs10052957 GG, and AGT rs4762 GA/AA genotypes exhibited significantly higher incidence of nephropathy. Individuals with ADIPOQ rs17300539 AA/AG and NR3C1 rs10052957 GG genotypes had a significantly higher incidence of retinopathy compared to others.CONCLUSIONSThe study demonstrated that the ADIPOQ rs17300539, AGT rs699, AGTR1 rs5186, and AGTR2 rs11091046 polymorphisms are associated with an increased susceptibility to MetS. Significant results concerning clinical features and complications were also observed. Further research is necessary to elucidate the relationship between susceptibility to MetS, clinical and laboratory characteristics, and epigenetic modifications.