Objectives <p>This study aims to evaluate the change of plasma Metrnl and its association with lipid metabolic dysregulation (LMD), insulin resistance and sensitivity among Vietnamese type 2 diabetes (T2D) with or without dyslipidemia.</p> Methods <p>This cross-sectional descriptive study, performed on 100 healthy control (HC group) and 100 T2D patients with non lipid metabolic dysregulation (NLMD groups) and 100 T2D patients with LMD (LMD group) from 2021 to 2023. The concentration of biochemists in plasma was measured automatically, and the test result accuracy was managed strictly. The Metrnl concentration in plasma was measured by ELISA. The insulin tolerance indices (HOMA-IR, HOMA2-IR, HOMA2-%S and HOMA2-%B) were calculated by a software. The Metrnl concentration was compared between HC and T2D with LMD and NLMD groups as well as insulin tolerance indices level-based groups.</p> Results <p>T2D with LMD groups showed the highest rate of “High” HOMA2-IR (92.93%) and “High” insulin (84.85%), followed by T2D with NLMD (81.0% and 70%) and HC group, respectively (p = 0.000). T2D patients showed higher rates of “Low” HOMA2-%B (91.92% for LMD and 95% for NLMD, significantly higher than HC group (p = 0.000). T2D patients showed a slight decrease of Metrnl, and the decrease was significant in female groups, compared to HC. The tendency of decreased Metrnl was observed from HC to NLMD to LMD, and the significant decrease occurred in ≥ 60-year-old sub-group. In addition, participants with “Low” level of insulin and “High” level of HOMA2-%S showed significantly higher concentration of Metrnl. Also, the Metrnl concentration was significantly higher in “Low-HOMA2-IR” group than in “High-HOMA2-IR” group.</p> Conclusion <p>The decrease of Metrnl was associated with T2D, T2D with dyslipidemia, insulin resistance and sensitivity among Vietnamese T2D patients.</p>