Background Glioblastoma (GBM) is an aggressive form of glioma. Even with standard-of-care Stupp protocol (surgery, radiotherapy, and temozolomide), median overall survival is only 10-12 months in population-based studies. Metabolic reprogramming is a hallmark of glioblastoma, with energy metabolism aberrantly geared towards aerobic fermentation. The prevalence of metabolic syndrome is 16% in the general NZ population and 32% in the Maori population.

Objectives We aimed to determine 1) if metabolic syndrome was more prevalent in our GBM cohort compared to general NZ population 2) if metabolic syndrome was associated with worse overall survival in GBM 3) if ethnicity influenced survival outcomes.

Methods We performed a retrospective analysis of 170 patients diagnosed and treated for GBM between 2005–2020 in one institution. Clinical and biochemical data relating to metabolic syndrome were collected. Overall survival was determined from the date of initial a surgical diagnosis to the date of death or data acquisition.

Results 18.2% of GBM patients met the criteria for metabolic syndrome, 27.7% of Maori and 16.1% of European New Zealanders. Patients with metabolic syndrome had statistically significant worse overall survival compared to those patients without metabolic syndrome regardless of treatment [mean 9.7 vs 18.4 months] p= 0.016 (p≤0.05). Power was too low to comment on the prevalence of metabolic syndrome or ethnicity.

Conclusion Our study demonstrates that metabolic syndrome is associated with statistically significant poorer outcome in GBM patients. Consequently, this data will provide a control group for our current prospective study investigating the antineoplastic effects of metabolic therapies in GBM.