Prevalence of metabolic syndrome in Nepal: A systematic review of all published studies
Keywords:
metabolic syndrome, Nepal, Prevalence, systematic review, type 2 diabetes mellitusAbstract
Background and aim: Metabolic syndrome (MetS) encompasses a cluster of medical conditions that significantly increase the risk of type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), cancer, and stroke. The global prevalence of MetS is rising, with a notable increase across South Asian countries. Multiple studies from diverse regions of Nepal, examining both general and clinical populations, have documented high MetS prevalence rates. This systematic review aims to determine the comprehensive prevalence of MetS in Nepal.
Methods: We conducted systematic searches across PubMed, Web of Science, Scopus, and EMBASE databases. Our review included all studies reporting MetS prevalence in Nepal among individuals aged 15 years and older, regardless of the study setting. We calculated the weighted mean prevalence and assessed study quality using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies.
Results: In the general population, the weighted mean prevalence of MetS ranged from 17.11% to 18.41%, varying by diagnostic criteria. MetS prevalence was higher among women, older adults, and individuals with lower educational attainment. Among populations with existing medical conditions, MetS prevalence was highest in patients with T2DM (90.36%) and lowest in those with Psoriasis (20.83%).
Conclusions: This systematic review evaluates the burden of MetS in Nepal's population. Although our findings demonstrate the substantial prevalence of MetS, interpretation must consider the variability in diagnostic criteria across studies and the predominant focus on major urban centers.
References
Punthakee Z, Goldenberg R, Katz P. Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Can J Diabetes [Internet]. 2018;42:S10–5. Available from: https://doi.org/10.1016/j.jcjd.2017.10.003
Fahed G, Aoun L, Zerdan MB, et al. Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. Int J Mol Sci. 2022;23(2). https://doi.org/10.3390/ijms23020786
Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol. 2008;28(4):629–36. https://doi.org/10.1161/ATVBAHA.107.151092
Achmad WP, Sanusi H, Parewangi AML, Bakri S, Iskandar H, Seweng A. Obesity’s impact on metabolic syndrome clusters and fatty liver incidence in millennial subjects. Acta Biomed. 2024;95(2):1–8. 10.23750/abm.v95i2.15323
Lazarus J V., Mark HE, Anstee QM, et al. Advancing the global public health agenda for NAFLD: a consensus statement. Nat Rev Gastroenterol Hepatol. 2022;19(1):60–78. https://doi.org/10.1038/s41575-021-00523-4
Liang X, Or B, Tsoi MF, Cheung CL, Cheung BMY. Prevalence of metabolic syndrome in the United States National Health and Nutrition Examination Survey 2011–18. Postgrad Med J. 2023;99(1175):985–92. https://doi.org/10.1093/postmj/qgad008
Li R, Li W, Lun Z, et al. Prevalence of metabolic syndrome in mainland China: A meta-analysis of published studies. BMC Public Health. 2016;16(1):1–10. https://doi.org/10.1186/s12889-016-2870-y
Krishnamoorthy Y, Rajaa S, Murali S, Rehman TI, Sahoo J, Sekhar KarID S. Prevalence of metabolic syndrome among adult population in India: A systematic review and meta-analysis. 2020; Available from: https://doi.org/10.1371/journal.pone.0240971
Ziaul M, Chowdhury I, Anik AM, et al. Prevalence of metabolic syndrome in Bangladesh : a systematic review and meta- analysis of the studies. BMC Public Health. 2018;18(1):1–14. https://doi.org/10.1186/s12889-018-5209-z
Nam JY, Kim J, Cho KH, et al. Associations of sitting time and occupation with metabolic syndrome in South Korean adults: A cross-sectional study. BMC Public Health [Internet]. 2016;16(1):1–10. Available from: http://dx.doi.org/10.1186/s12889-016-3617-5
Mehata S, Shrestha N, Mehta RK, Bista B, Pandey AR, Mishra SR. Prevalence of the Metabolic Syndrome and its determinants among Nepalese adults: Findings from a nationally representative cross-sectional study. Sci Rep [Internet]. 2018 Oct;8(1):14995: https://doi.org/10.1038/s41598-018-33177-5
Rodríguez-Monforte M, Sánchez E, Barrio F, Costa B, Flores-Mateo G. Metabolic syndrome and dietary patterns: a systematic review and meta-analysis of observational studies. Eur J Nutr. 2017;56(3):925–47. https://doi.org/10.1007/s00394-016-1305-y
Hamadeh, N., Van Rompaey, C., & Metreau E. New World Bank Group country classifications by income level: FY24. World Bank Blogs. Retrieved from https://blogs.worldbank.org/en/opendata/new-world-bank-group-country-classifications-income-level-fy24.
World Health Organization (WHO). Non-communicable diseases [Internet]. 2023 [cited 2024 Apr 29]. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
Sharma K, Poudyal S, Subba HKHK, Khatiwada S. Metabolic syndrome and life style factors among diabetes patients attending in a teaching hospital, Chitwan. PLoS One [Internet]. 2023;18(5 May):1–17. Available from: http://dx.doi.org/10.1371/journal.pone.0286139
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372. https://doi.org/10.1136/bmj.n71
Munn Z, MClinSc SM, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc. 2015;13(3):147–53. https://doi.org/10.1097/XEB.0000000000000054
Márquez-Sandoval F, MacEdo-Ojeda G, Viramontes-Hörner D, Fernández Ballart JD, Salas Salvadó J, Vizmanos B. The prevalence of metabolic syndrome in Latin America: A systematic review. Public Health Nutr. 2011;14(10):1702–13. https://doi.org/10.1017/S1368980010003320
Sharma SK, Ghimire A, Radhakrishnan J, et al. Prevalence of hypertension, obesity, diabetes, and metabolic syndrome in Nepal. Int J Hypertens [Internet]. 2011;2011. Available from: https://doi.org/10.4061/2011/821971
Zone J, Jha BK, Sherpa ML, Dahal BK, Singh JK. Prevalence of Metabolic Syndrome and Its Components in Adults with Central Obesity at. 2020;18(4):681–5. https://doi.org/10.33314/jnhrc.v18i4.2890
Sharma D, Baidya SG, Raut R, et al. Prevalence of metabolic syndrome in a suburban community of Nepal. Nepal Hear J [Internet]. 2017;6(1):5–7. Available from: https://doi.org/10.3126/njh.v6i1.18447
Shrestha R, Jha SC, Khanal M, Gyawali P, Yadav BK, Jha B. Association of cardiovascular risk factors in hypertensive subjects with metabolic syndrome defined by three different definitions. J Nepal Med Assoc. 2011;51(4):157–63. https://doi.org/10.31729/jnma.9
Shrestha S, Chandra L, Aryal M, Das BKL, Pandey S, Baral N. Evaluation of lipid peroxidation and antioxidants’ status in metabolic syndrome. Kathmandu Univ Med J [Internet]. 2010;8(32):382–6. Available from: https://doi.org/10.3126/kumj.v8i4.6236
Baniya S, Shrestha TM, Pant P, Aacharya RP. Metabolic Syndrome among Stable Chronic Obstructive Pulmonary Disease Patients Visiting Outpatient Department of a Tertiary care centre: A Descriptive Cross-sectional Study. J Nepal Med Assoc [Internet]. 2023;61(260):355–8. Available from: https://doi.org/10.31729/jnma.7719
Giri A, Joshi A, Shrestha S, Chaudhary A. Metabolic Syndrome among Patients with Polycystic Ovarian Syndrome Presenting to a Tertiary Care Hospital: A Descriptive Cross-Sectional Study. J Nepal Med Assoc [Internet]. 2022 Feb;60(246):137–41. Available from: https://doi.org/10.31729/jnma.7221
Singh NK, Karki L. Metabolic Syndrome in Patients with Chronic Obstructive Pulmonary Disease in Medicine Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study. J Nepal Med Assoc. 2021;59(236):313–6. ; https://doi.org/10.31729/jnma.6410
Vaidya B, Baral R, Lama LDD, Joshi R, Bhochhibhoya M, Nakarmi S. A study of metabolic parameters in patients with gout: A single center study from nepal. Endocrine, Metab Immune Disord - Drug Targets [Internet]. 2021;21(6):1090–5. Available from: https://doi.org/10.2174/1871530320999200818141032
Sapkota M, Timilsina A, Shakya M, et al. Metabolic syndrome and diabetes risk among young adult students in the health sciences from kathmandu, nepal. Drug Healthc Patient Saf [Internet]. 2020;12:125–33. Available from: https://doi.org/10.2147/DHPS.S258331
Tamrakar R, Shrestha A, Tamrakar D. Prevalence of metabolic syndrome in newly diagnosed type 2 diabetes mellitus. Kathmandu Univ Med J. 2019;17(68):273–8. PMID:33311035
Pardhe BD, Shakya S, Bhetwal A, et al. Metabolic syndrome and biochemical changes among non-alcoholic fatty liver disease patients attending a tertiary care hospital of Nepal. BMC Gastroenterol [Internet]. 2018 Jul;18(1):1–8. Available from: https://doi.org/10.1186/s12876-018-0843-6
Pandey S, Baral N, Majhi S, et al. Prevalence of the metabolic syndrome in acute myocardial infarction and its impact on hospital outcomes. Int J Diabetes Dev Ctries. 2009;29(2):52–5. https://doi.org/10.4103/0973-3930.53120
Thapa P, Paudel S, Uprety S, Timalsina S. Metabolic Syndrome among Patients with Psoriasis Attending the Outpatient Department of Dermatology, Venereology and Leprology in a Tertiary Care Centre: A Descriptive Cross-sectional Study. J Nepal Med Assoc. 2023;61(263):604–7. https://doi.org/10.31729/jnma.8225
Pokharel DRDR, Khadka D, Sigdel M, et al. Prevalence of metabolic syndrome in Nepalese type 2 diabetic patients according to WHO, NCEP ATP III, IDF and Harmonized criteria. J Diabetes Metab Disord [Internet]. 2014;13(1):1–13. Available from: https://doi.org/10.1186/s40200-014-0104-3
Tamang HK, Timilsina U, Thapa S, et al. Prevalence of metabolic syndrome among Nepalese type 2 diabetic patients. [Internet]. Vol. 15, Nepal Medical College journal : NMCJ. H.K. Tamang; 2013. p. 50–5. Available from: https://www.embase.com/search/results?subaction=viewrecord&id=L372744884&from=export; PMID:24592795
Poudel B, Gyawali P, Yadav BK, et al. Prevalence of metabolic syndrome in chronic kidney disease: a hospital based cross-sectional study. J Nepal Health Res Counc. 2013;11(24):208–11. PMID:24362613
Shin S, Jee H. Prevalence of metabolic syndrome in the Gulf Cooperation Council countries: Meta-analysis of cross-sectional studies. J Exerc Rehabil. 2020;16(1):27–35. https://doi.org/10.12965/jer.1938758.379
Bowo-Ngandji A, Kenmoe S, Ebogo-Belobo JT, et al. Prevalence of the metabolic syndrome in African populations: A systematic review and meta-analysis. Vol. 18, PLoS ONE. 2023. 1–34 p. https://doi.org/10.1371/journal.pone.0289155
Mbugua SM, Kimani ST, Munyoki G. Metabolic syndrome and its components among university students in Kenya. BMC Public Health. 2017;17(1):1–8. https://doi.org/10.1186/s12889-017-4936-x
Ali N, Samadder M, Shourove JH, Taher A, Islam F. Prevalence and factors associated with metabolic syndrome in university students and academic staff in Bangladesh. Sci Rep [Internet]. 2023;13(1):1–10. Available from: https://doi.org/10.1038/s41598-023-46943-x
Manaf MRA, Nawi AM, Tauhid NM, et al. Prevalence of metabolic syndrome and its associated risk factors among staffs in a Malaysian public university. Sci Rep [Internet]. 2021;11(1):1–11. Available from: https://doi.org/10.1038/s41598-021-87248-1
Bilog NC, Mekoulou Ndongo J, Bika Lele EC, et al. Prevalence of metabolic syndrome and components in rural, semi-urban and urban areas in the littoral region in Cameroon: impact of physical activity. J Heal Popul Nutr [Internet]. 2023;42(1):1–12. Available from: https://doi.org/10.1186/s41043-023-00415-0
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation. 2005;112(17):2735–52. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
Demissie, B.M., Girmaw, F., Amena, N. et al. Prevalence of metabolic syndrome and associated factors among patient with type 2 diabetes mellitus in Ethiopia, 2023: asystematic review and meta analysis. BMC Public Health 24, 1128 (2024). https://doi.org/10.1186/s12889-024-18580-0
Abagre, T.A., Bandoh, D.A. & Addo-Lartey, A.A. Determinants of metabolic syndrome among patients attending diabetes clinics in two sub-urban hospitals: Bono Region, Ghana. BMC Cardiovasc Disord 22, 366 (2022). https://doi.org/10.1186/s12872-022-02805-4
Karee M, Gundabattula SR, Sashi L, Boorugu H, Chowdhury A. Prevalence of metabolic syndrome in women with polycystic ovary syndrome and the factors associated: A cross sectional study at a tertiary care center in Hyderabad, south-eastern India. Diabetes Metab Syndr. 2020 Jul-Aug;14(4):583-587. doi: 10.1016/j.dsx.2020.05.006. Epub 2020 May 11. PMID: 32416528.
Khorshidi A, Azami M, Tardeh S, Tardeh Z. The prevalence of metabolic syndrome in patients with Polycystic Ovary Syndrome: A systematic review and meta-analysis. Diabetes Metab Syndr Clin Res Rev [Internet]. 2019;13(4):2747–53. Available from: https://doi.org/10.1016/j.dsx.2019.06.008
Noor SK, Hamid S, Abdelgeyoom AE, et al. The prevalence of metabolic syndrome among adult patients with chronic kidney disease: an overlooked problem in Sudan. J Public Heal Emerg. 2022;6. https://doi.org/10.21037/jphe-22-4
Tadewos A, Egeno T, Amsalu A. Risk factors of metabolic syndrome among hypertensive patients at Hawassa University comprehensive specialized hospital, Southern Ethiopia. BMC Cardiovasc Disord. 2017;17(1):1–9. https://doi.org/10.1186/s12872-017-0648-5
Christian AK, Sanuade OA, Kushitor SB, et al. Metabolic syndrome among individuals living with hypertension in Accra, Ghana. PLoS One [Internet]. 2021;16(10 October):1–14. Available from: http://dx.doi.org/10.1371/journal.pone.0253837
Cebron Lipovec N, Beijers RJHCG, van den Borst B, Doehner W, Lainscak M, Schols AMWJ. The Prevalence of Metabolic Syndrome In Chronic Obstructive Pulmonary Disease: A Systematic Review. COPD J Chronic Obstr Pulm Dis [Internet]. 2016;13(3):399–406. Available from: http://dx.doi.org/10.3109/15412555.2016.1140732
Keeratichananont W, Kaenmuang P, Geater SL, Manoret P, Thanapattaraborisuth B. Prevalence, associated factors, and clinical consequences of metabolic syndrome in chronic obstructive pulmonary disease patients: a 5-year prospective observational study. Ther Adv Respir Dis. 2023;17:1–10. https://doi.org/10.1177/17534666231167342
Damiri B, Abualsoud MS, Samara AM, Salameh SK. Metabolic syndrome among overweight and obese adults in Palestinian refugee camps. Diabetol Metab Syndr [Internet]. 2018;10(1):1–11. Available from: https://doi.org/10.1186/s13098-018-0337-2
Uppalakal B, Karanayil LS. Incidence of metabolic syndrome in patients admitted to medical wards with ST elevation myocardial infarction. J Clin Diagnostic Res. 2017;11(3):OC17–20. https://doi.org/10.7860/JCDR/2017/24803.9481
Nguyen NT, Nguyen TN, Nguyen KM, Tran HPN, Huynh KLA, Hoang S Van. Prevalence and impact of metabolic syndrome on in-hospital outcomes in patients with acute myocardial infarction: A perspective from a developing country. Med (United States). 2023;102(45):E35924. https://doi.org/10.1097/MD.0000000000035924
Doualla-Bija M, Lobe Batchama Y, Moutchia-Suh J, et al. Prevalence and characteristics of metabolic syndrome in gout patients in a hospital setting in sub-Saharan Africa. Diabetes Metab Syndr Clin Res Rev [Internet]. 2018;12(6):1007–11. Available from: https://doi.org/10.1016/j.dsx.2018.06.015
Fattahi MR, Niknam R, Safarpour A, Sepehrimanesh M, Lotfi M. The Prevalence of Metabolic Syndrome In Non-alcoholic Fatty Liver Disease; A Population-Based Study. Middle East J Dig Dis [Internet]. 2016;8(2):131–7. Available from: http://dx.doi.org/10.15171/mejdd.2016.18
Liu L, Cai XC, Sun XY, et al. Global prevalence of metabolic syndrome in patients with Psoriasis in the past two decades: current evidence. J Eur Acad Dermatology Venereol. 2022;36(11):1969–79. https://doi.org/10.1111/jdv.18296
Singh S, Dogra S, Shafiq N, Bhansali A, Malhotra S. Prevalence of Metabolic Syndrome in Psoriasis and Levels of Interleukin-6 and Tumor Necrosis Factor-α in Psoriasis Patients with Metabolic Syndrome: Indian Tertiary Care Hospital Study. Int J Appl Basic Med Res [Internet]. 2017;7(3). Available from: https://doi.org/10.4103/ijabmr.ijabmr_330_16
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