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Review
. 2025 May;477(5):669-680.
doi: 10.1007/s00424-024-03051-7. Epub 2025 Jan 25.

Epidemiology of metabolic syndrome

Iris Pigeot  1   2 , Wolfgang Ahrens  3
Affiliations
Review

Epidemiology of metabolic syndrome

Iris Pigeot et al. Pflugers Arch. 2025 May.

Abstract

The global increase of overweight and obesity in children and adults is one of the most prominent public health threats, often accompanied by insulin resistance, hypertension, and dyslipidemia. The simultaneous occurrence of these health problems is referred to as metabolic syndrome. Various criteria have been proposed to define this syndrome, but no general consensus on the specific markers and the respective cut-offs has been achieved yet. As a consequence, it is difficult to assess regional variations and temporal trends and to obtain a comprehensive picture of the global burden of this major health threat. This limitation is most striking in childhood and adolescence, when metabolic parameters change with developmental stage. Obesity and related metabolic disorders develop early in life and then track into adulthood, i.e., the metabolic syndrome seems to originate in the early life course. Thus, it would be important to monitor the trajectories of cardio-metabolic parameters from early on. We will summarize selected key studies to provide a narrative overview of the global epidemiology of the metabolic syndrome while considering the limitations that hinder us to provide a comprehensive full picture of the problem. A particular focus will be given to the situation in children and adolescents and the risk factors impacting on their cardio-metabolic health. This summary will be complemented by key findings of a pan-European children cohort and first results of a large German adult cohort.

Keywords: Cardio-metabolic risk factors; Dyslipidemia; Hypertension, Insulin resistance; Obesity; Prevalence.

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Conflict of interest statement

Declarations. IDEFICS/I.Family Cohort Ethical Approval: During the IDEFICS and I.Family studies, all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed. Approval by following ethics committees was obtained by each of the centers doing the fieldwork: Ethics Committee of the Gent University Hospital (Belgium); Cyprus National Bioethics Committee (Cyprus); Tallinn Medical Research Ethics Committee (TMREC, Estonia); Ethics Committee of the University of Bremen (Germany); Ethics Committee of the Local Health Authority (ASL) in Avellino (Italy); Ethics Committee for Clinical Research of Aragon (CEICA, Spain); Regional Ethics Research Board in Gothenburg (Sweden); Bioethical Committee of the University of Rzeszów (Poland). Consent to participate: Children who participated in the IDEFICS and I.Family studies did not undergo any procedure before both, they and their parents had given consent for examinations, collection of samples, subsequent analysis and storage of personal data and collected samples. Study subjects and their parents could consent to single components of the study while abstaining from others. Funding: The IDEFICS study ( www.idefics.eu ) was financially supported by the European Commission within the Sixth RTD Framework Programme Contract No. 016181 (FOOD). The I.Family study ( www.ifamilystudy.eu ) was funded by the European Commission within the Seventh RTD Framework Programme Contract No. 266044 (KBBE 2010–14). Additional resources were invested by all participating partners. Availability of data and materials: The use of data of the IDEFICS/I.Family cohort requires a mutual agreement between the study consortia and interested third parties on a case-by-case basis. Corresponding requests can be sent to the study coordinator: i.family@leibniz-bips.de. NAKO Ethical Approval: The German National Cohort (NAKO) study is performed with the approval of the relevant ethics committees, and is in accordance with national law and with the Declaration of Helsinki of 1975 (in the current, revised version). https://nako.de/allgemeines/was-ist-die-nako-gesundheitsstudie/ethik-in-der-nako/ Consent to participate: Written informed consent was obtained from all participants. Funding: This project was conducted with data from the German National Cohort (NAKO) ( www.nako.de ). The NAKO is funded by the Federal Ministry of Education and Research (BMBF) [project funding reference numbers: 01ER1301A/B/C, 01ER1511D, and 01ER1801A/B/C/D], federal states of Germany and the Helmholtz Association, the participating universities and the institutes of the Leibniz Association. We thank all participants who took part in the NAKO study and the staff of this research initiative. Availability of data and materials: Access to and use of NAKO data and biosamples can be obtained via an electronic application portal (https://transfer.nako.de).

Figures

Fig. 1
Fig. 1
Remission rates of overweight/obesity for children of the IDEFICS cohort between baseline and first follow-up (red line: weighted average remission rate over all age groups; blue line: age-specific remission rate)
Fig. 2
Fig. 2
Temporal sequence of the first three examination waves of the IDEFICS/I.Family cohort
Fig. 3
Fig. 3
Five latent groups identified by latent transition analysis where percentages represent the estimated probabilities of a child having elevated values (≥ P90)
See this image and copyright information in PMC

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