Objective To explore the changes in serum concentrations of irisin, vaspin and reactive oxygen species (ROS) in patients with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS), and to investigated the correlation of irisin and vaspin with clinical parameters of MS. Methods A total of 260 T2DM patients were enrolled. Age and gender were recorded, anthropometrics, biochemical parameters, and levels of irisin, vaspin and ROS in fasting serum were measured, and homeostatic model assessment of insulin resistance (HOMA-IR) calculated. Wilcoxon rank sum test, correlation analysis, Logistic regression analysis, multiple linear regression analysis and receiver operating characteristic (ROC) curve analysis were performed. Results Compared to T2DM patients without MS, T2DM patients with MS had lower serum level of irisin [male: 112.81(86.96-191.84)μg/L vs. 156.23(110.61-225.97)μg/L, female: 141.09(77.52-175.55)μg/L vs. 172.15(95.69-240.37)μg/L, P<0.01], higher levels of vaspin and ROS [male: 1.13(0.95-1.38)μg/L vs. 0.36(0.21-0.82)μg/L, 1 540(1 250-1 860)kU/L vs. 1 020(920-1 350)kU/L; female: 1.52(1.13-1.80)μg/L vs. 0.51(0.47-1.08)μg/L, 1 650(1 320-1 940)kU/Lvs. 1 120(980-1 420)kU/L, P<0.01]. In the T2DM patients, serum irisin level was negatively correlated with vaspin (r=-0.382, P<0.01) and ROS (r=-0.410, P<0.01), while vaspin was positively correlated with ROS (r=0.400, P<0.01). Multiple linear regression analyses showed that irisin was significantly correlated with body mass index (BMI), waist circumference and triglyceride, while vaspin was correlated with gender, BMI, and waist circumference (all P<0.05). Logistic regression analysis revealed that irisin, vaspin and ROS were all associated with MS (OR=0.77, 95% CI 0.608-0.978; OR=1.39, 95% CI 1.252-1.539; OR=1.38, 95% CI 1.112-1.718, all P<0.05). ROC analysis demonstrated that irisin and vaspin had significant area under the curve (AUC=0.931, P<0.01; AUC=0.777, P<0.01) for the prediction of MS. Conclusions Serum irisin level was significantly decreased, while vaspin and ROS were significantly increased in T2DM patients with MS. Irisin and vaspin were associated with clinical presentations of MS, suggesting that irisin and vaspin might be valuable predictors of MS. Key words: Metabolic syndrome; Diabetes mellitus; Reactive oxygen species; Irisin; Vaspin