Worldwide trends in metabolic syndrome from 2000 to 2023: a systematic review and modelling analysis

Abstract

Metabolic syndrome (MetS), a cluster of conditions including abdominal obesity, high blood pressure, and abnormal blood sugar and lipid levels, is a growing global health concern, yet its global burden remains poorly characterized. Here we show trends in MetS prevalence from 2000 to 2023, based on a systematic review and Bayesian modelling of 3236 data points with 45,549,151 adults. Between 2000 and 2023, prevalence rose from 14.7% (13.1-16.7) to 31.0% (28.5-33.9) among women, and from 9.0% (6.9-12.1) to 25.7% (21.5-31.1) among men. In 2023, an estimated 1.54 billion adults (1.35-1.76) had MetS globally: 846 million (776-924) women and 692 million (579-837) men. Prevalence increased with age, urbanicity, and income level, ranging from 7.5% to 45.0% among women and 6.5% to 59.6% among men across regions. Among both women and men, prevalence increased in 196 countries and territories. These findings call for targeted interventions to address the rising global burden.

Fig. 1. Global and regional temporal trends of metabolic syndrome prevalence by sex, 2000–2023.

Time trends of metabolic syndrome prevalence (%) for women (in red) and men (in blue) at global level and in regions. Each panel shows the prevalence trajectory from 2000 to 2023. Central lines are bounded by a semi-transparent band representing the 95% credible intervals. Panels share a common y scale to facilitate regional comparisons.

Fig. 2. Decomposition of changes in prevalent metabolic syndrome cases by sex, 2000–2023.

Stacked decomposition of net change in prevalent metabolic syndrome cases (absolute counts) between 2000 and 2023 for women (left) and men (right). Bars show the reference number of cases in 2000 and the total cases in 2023; intermediate segments decompose the net change into the population effect (change due to population growth/age structure), prevalence effect (change due to shifts in age-specific prevalence), and interaction effect (joint effect of population and prevalence changes). Y axis: number of prevalent cases; X axis: year (2000 baseline and subsequent years shown).

Fig. 3. Metabolic syndrome prevalence by sex across national income and urbanicity groups in 2023.

Prevalence of metabolic syndrome (%) in men (in blue) and women (in red) stratified by national income group (top) and national urbanicity group (bottom). Bars represent prevalence estimates for each sex and category; percentage values shown on the figure indicate the point estimates. Error bars denote the 95% credible intervals. Estimates were derived from modelling analysis.

Fig. 4. Age-sex distribution of prevalent metabolic syndrome cases, 2023.

Number of prevalent cases of metabolic syndrome by 5-year age group for men (left) and women (right). Bars show prevalent cases of metabolic syndrome (should be ×1000). Numeric labels on bars indicate point estimates.

Fig. 5. Heatmap of metabolic syndrome prevalence in 2023 by age group and region, stratified by sex.

Heatmap showing the prevalence of metabolic syndrome (%) in 2023 across world regions and age groups, separately for men and women. Cell shading indicates the prevalence within each stratum. The heatmap highlights both the age gradient of metabolic syndrome prevalence and regional heterogeneity. The colour scale ranges from green (lower prevalence) to red (higher prevalence), with darker shading reflecting greater burden.

Fig. 6. Global map of metabolic syndrome prevalence in 2023 among women.

Choropleth map showing country-level prevalence of metabolic syndrome (%) in 2023. Country polygons are shaded on a continuous colour scale from green (low prevalence) to red (high prevalence); darker, more saturated colours indicate higher prevalence.

Fig. 7. Global map of metabolic syndrome prevalence in 2023 among men.

Choropleth map showing country-level prevalence of metabolic syndrome (%) in 2023. Country polygons are shaded on a continuous colour scale from green (low prevalence) to red (high prevalence); darker, more saturated colours indicate higher prevalence.

Fig. 8. Prevalence of metabolic syndrome among men and women by country in different regions.

This figure presents estimates of metabolic syndrome prevalence (%) in men and women across countries, with credible intervals shown in brackets. Data are organized by regions (Sub-Saharan Africa, Central Asia and Middle East/North Africa, East and Southeast Asia, Oceania, Latin America and the Caribbean, South Asia, High-income Asia Pacific, Central and Eastern Europe, and High-income Western countries). National estimates highlight within-region variation, while regional groupings provide a comparative overview of global patterns in metabolic syndrome.

Fig. 9. Country-level metabolic syndrome prevalence in 2000 versus 2023, stratified by sex.

Scatterplot of country-level prevalence of metabolic syndrome (%) in 2000 (x-axis) and 2023 (y-axis). Each dot represents one country, coloured by its region; facets show women (top) and men (bottom). The black square indicates the global prevalence. Reference lines aid interpretation: the grey diagonal (y = x) marks equal prevalence in 2000 and 2023, the blue line (y = 2x) indicates a doubling, and the red line (y = 3x) indicates a tripling of prevalence. Countries above the grey line experienced increases in prevalence, while those below experienced declines.