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Global Metabolic Syndrome Prevalence More Than Doubled from 2000 to 2023, Study Finds

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Global Study: Metabolic Syndrome Prevalence More Than Doubles Since 2000

A comprehensive global study published in Nature Communications reports that the prevalence of metabolic syndrome among adults more than doubled between 2000 and 2023, rising from 11.9% to 28.4%.

The research, based on a systematic review and modeling analysis of data from 597 studies and over 45.5 million participants across 198 countries, estimates that approximately 1.54 billion adults were living with the condition in 2023.

Study Methodology and Definition

The research team conducted a systematic review of population-based observational studies reporting metabolic syndrome prevalence in adults. Data were sourced from multiple databases, including PubMed, Excerpta Medica Database (EMBASE), Web of Science, African Journals Online, and Global Index Medicus.

  • Metabolic syndrome was defined using the harmonized Joint Interim Statement framework, requiring the presence of at least three of five components: elevated fasting plasma glucose, raised blood pressure, elevated triglycerides, low high-density lipoprotein (HDL) cholesterol, and central obesity.
  • To estimate global, regional, and national trends from 2000 to 2023, researchers employed a Bayesian multilevel logistic regression model. This model incorporated annual time-varying covariates, including age distribution, GDP per capita, and urbanicity.
  • The study's authors noted that many country-level estimates are model-derived rather than directly observed and carry associated uncertainty intervals. Nationally representative data were available from 44 countries.

Key Global and Demographic Findings

The analysis revealed significant increases in metabolic syndrome prevalence across nearly all countries and demographic groups.

  • Global Increase: The overall global prevalence rose from 11.9% in 2000 to 28.4% in 2023.
  • Sex Differences: Prevalence increased for both sexes, rising from 14.7% to 31.0% among women and from 9.0% to 25.7% among men. By 2023, an estimated 846 million women and 692 million men were living with the condition.
  • Age Patterns: Prevalence rose consistently with age, peaking in the 65-74 age group. Women surpassed men in prevalence after age 45 in most regions. The number of cases (case burden) peaked among women aged 50-54 (82.8 million) and men aged 35-39 (84.3 million).
  • Geographic Spread: Prevalence increased in 196 of the 198 studied countries for both sexes.

Regional Variations and Burden

The study identified substantial regional differences in both prevalence levels and the scale of increase.

  • 2023 Prevalence Range: In 2023, prevalence ranged from 7.5% to 45.0% among women and from 6.5% to 59.6% among men across different regions.
  • Areas of Highest Increase: The largest increases in prevalence occurred in East Asia among women (a 28.1 percentage point increase) and in Central Europe among men (a 42.7 percentage point increase).
  • Global Burden: East Asia and South Asia accounted for the greatest share of the global burden. East Asia alone had an estimated 212 million women and 157 million men affected in 2023.
  • Highest and Lowest Prevalence: In 2023, the highest prevalence levels were observed in Bermuda and Puerto Rico among women, and in Bermuda and the Czech Republic among men. The lowest prevalence was found in Sub-Saharan Africa and select Asian countries.
  • Socioeconomic Factors: Prevalence generally rose with higher income and greater urbanicity. However, the study found that women in lower-income and less urbanized settings carried a disproportionately higher burden of metabolic syndrome compared to men in similar settings.

Context and Limitations

Metabolic syndrome is a cluster of interrelated metabolic abnormalities, including obesity, insulin resistance, hypertension, dyslipidemia, and elevated fasting glucose. Its individual components are among the leading drivers of global mortality and disability-adjusted life years.

The study's authors identified several limitations, including regional data gaps, the model-derived nature of many country estimates, and the inclusion of studies that used different diagnostic criteria before standardization.

They concluded that metabolic syndrome represents a growing global public health challenge and is a clinically valuable construct for identifying individuals at elevated risk for type 2 diabetes, cardiovascular disease, chronic kidney disease, and premature mortality.