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Meta-Analysis
. 2024 Mar 7;14(3):e074659.
doi: 10.1136/bmjopen-2023-074659.

Prevalence of metabolic syndrome in patients with inflammatory bowel disease: a systematic review and meta-analysis

Zhaofeng Shen #  1 , Mengyuan Zhang #  2 , Yijing Liu #  2 , Changchang Ge  2 , Yi Lu  2 , Hong Shen  3 , Lei Zhu  4
Affiliations
Meta-Analysis

Prevalence of metabolic syndrome in patients with inflammatory bowel disease: a systematic review and meta-analysis

Zhaofeng Shen et al. BMJ Open. .

Abstract

Objectives: Patients with inflammatory bowel disease (IBD) may experience comorbidities involving metabolic syndrome (MetS). However, this association remains controversial. Our objective was to estimate the prevalence of MetS in patients with IBD and assess whether MetS is more strongly associated with ulcerative colitis (UC) or Crohn's disease (CD).

Design: Systematic review and meta-analysis.

Data sources: PubMed, Cochrane Library, Web of Science, EMBASE and MEDLINE were searched from their inception to July 2022.

Eligibility criteria: Observational studies reporting data regarding the rate of comorbid MetS among patients with IBD and published in English.

Data extraction and synthesis: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology reporting guidelines were followed. Pooled prevalence, ORs and 95% CIs were calculated using random-effects models. The Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality checklist were used. Heterogeneity, sensitivity and stratified analyses were performed using R (V.4.2.1).

Results: 11 eligible studies involving 2501 patients were included. Of these studies, four reported MetS prevalence separately by IBD phenotype, and only one contained a non-IBD comparison group. Overall, the methodological quality of the included studies was moderate. The pooled prevalence of MetS in IBD was 19.4% (95% CI 15.1% to 23.8%), with a moderate heterogeneity (I2=51.8%, Cochrane Q statistic=12.4, p=0.053). Stratified analyses demonstrated that the aggregate estimate of comorbid MetS was significantly higher in UC than in CD (38.2% vs 13.6%, χ2=4.88, p=0.03). We found a positive association between MetS and UC compared with CD (OR=2.11, 95% CI 1.19 to 3.74, p=0.01). Additionally, four studies identified that higher age was a risk factor associated with the development of MetS.

Conclusions: MetS is not rare in IBD, especially in UC. However, longitudinal studies are needed to further clarify the relationship between IBD and MetS.

Prospero registration number: CRD42022346340.

Keywords: Inflammatory bowel disease; QUALITATIVE RESEARCH; Systematic Review.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of the meta-analysis. This flow chart, which shows the whole process of literature retrieval, screening, inclusion and exclusion, is based on PRISMA framework. IBD, inflammatory bowel disease; MetS, metabolic syndrome; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
Risk of bias of included studies using the 11-item checklist recommended by the Agency for Healthcare Research and Quality. A navy blue dot denotes low risk of bias, orange for unclear risk of bias and light green for high risk of bias.
Figure 3
Figure 3
Forest plots for the overall pooled prevalence of comorbid metabolic syndrome among patients with inflammatory bowel disease.
Figure 4
Figure 4
Stratified analyses by type of inflammatory bowel disease. The summary estimates were obtained using a random-effects model. The diamond data markers indicate the pooled proportion. CD, Crohn’s disease; UC, ulcerative colitis.
See this image and copyright information in PMC

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