Metabolic syndrome among type 2 diabetic patients in Sub-Saharan African countries: A systematic review and meta-analysis

Abstract

Background and aims: Metabolic syndrome is one of the serious public health problems among type 2 diabetic patients. Despite a number of studies have been conducted, there is no overall estimation on the prevalence of metabolic syndrome among type 2 diabetic patients in Sub-Saharan African countries. Therefore, this study aimed to estimate the pooled prevalence of metabolic syndrome in patients with type 2 diabetes mellitus in Sub -Saharan African countries.

Methods: PubMed, Web of Science, African Journals Online, Google Scholar, Scopus, and Wiley Online Library databases from inception to April 27, 2020 were searched to identify relevant studies. The I² statistic was used to check heterogeneity across the included studies. DerSimonian and Laird random-effects model was applied to estimate pooled effect size, and 95% confidence interval across studies. A funnel plot and Egger's regression test were used to determine the presence of publication bias. Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. All statistical analyses were done using STATA™ Version 14 software.

Result: In this meta-analysis, a total of 23 studies with 6482 study participants were included. The estimated prevalence of metabolic syndrome in Sub-Saharan African countries was 59.62% (95% CI: 52.20, 67.03). Based on the subgroup analysis, the highest prevalence of metabolic syndrome (61.14%, 95% CI: 51.74, 70.53) was reported in Ethiopia. Additionally, the highest prevalence of metabolic syndrome was reported across studies using the diagnostic criteria of National Cholesterol Education Program Adult Treatment Panel III 64.8% (95% CI: 54.74, 74.86), followed by International Diabetic Federation (57.15%), and World health Organization (53.12%) definitions.

Conclusion: Almost two out of three type 2 diabetic patients in Sub-Saharan African countries have metabolic syndrome, which implies that its prevalence is high in patients with type 2 diabetes mellitus. Therefore, policymakers need to design efficient strategies and guideline to reduce and control the burden of metabolic syndrome and its impact among diabetic population.

Keywords: Metabolic syndrome; Prevalence; Sub-Saharan Africa; Type2 diabetes mellitus.