The prevalence of metabolic syndrome in South Asia: a systematic review

The objective of this study was to estimate the prevalence of metabolic syndrome and its individual components in South Asia region. A search was conducted on PubMed, Scopus and OvidSP (MedLine and EMBASE) using the term ‘metabolic syndrome’, ‘prevalence’ and the name of each South Asian country for studies published on or after the year 2000. Reference lists and citation references of the included papers were also checked. Eligibility criteria were mainly population-based studies on both gender and healthy participants aged ≥18 years. Four definitions of metabolic syndrome were considered: the World Health Organisation (1999), Third Adult Treatment Panel (2001) and its modified version (2005) and International Diabetes Federation (2005). A total of 558 papers were retrieved from all sources, of which 16 relevant studies were identified comprising 14,515 males (44.1 %) and 18,390 females (55.9 %). The weighted mean prevalence of metabolic syndrome was 14.0 % (WHO), 26.1 % (ATPIII), 29.8 % (IDF) and 32.5 % (modified ATPIII). Low levels of HDL cholesterol and hypertension were prevalent in half of the study population. Overall, females had a higher prevalence of MS under all definitions except WHO. Females were more likely to have low levels of HDL cholesterol (68.8 vs 37.9 %) and central obesity (47.9 vs 37.9 %), whereas males were comparatively more hypertensive (42.3 vs 38.1 %). Despite the high rates of metabolic risk factors, research is extremely sparse in South Asia preventing knowledge of actual burden. Along with the increased access to clinical intervention, prevention strategies should be intensified with special attention to females.