Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon.
Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
PLoS One. 2023 Jul 27;18(7):e0289155. doi: 10.1371/journal.pone.0289155. eCollection 2023.
The metabolic syndrome (MS) is a leading cause of death worldwide. Several studies have found MS to be prevalent in various African regions. However, no specific estimates of MS prevalence in African populations exist. The aim of this study was to estimate the overall prevalence of MS in the African populations.
A systematic review was conducted in PubMed, Web of Science, Africa Index Medicus, and African Journal Online Scopus to find studies published up to the 15th of August 2022. Pooled prevalence was calculated based on six diagnostic methods. The pooled prevalence of MS was estimated using a random-effects model. Our risk of bias analysis was based on the Hoy et al. tool. A Heterogeneity (I2) assessment was performed, as well as an Egger test for publication bias. PROSPERO number CRD42021275176 was assigned to this study.
In total, 297 studies corresponding to 345 prevalence data from 29 African countries and involving 156 464 participants were included. The overall prevalence of MS in Africa was 32.4% (95% CI: 30.2-34.7) with significant heterogeneity (I2 = 98.9%; P<0.001). We obtained prevalence rates of 44.8% (95% CI: 24.8-65.7), 39.7% (95% CI: 31.7-48.1), 33.1% (95% CI: 28.5-37.8), 31.6% (95% CI: 27.8-35.6) and 29.3% (95% CI: 25.7-33) using the WHO, revised NCEP-ATP III, JIS, NCEP/ATP III and IDF definition criteria, respectively. The prevalence of MS was significantly higher in adults >18 years with 33.1% (95%CI: 30.8-35.5) compared to children <18 years with 13.3% (95%CI: 7.3-20.6) (P<0.001). MS prevalence was significantly higher in females with 36.9% (95%CI: 33.2-40.7) compared to males with 26.7% (95%CI: 23.1-30.5) (P<0.001). The prevalence of MS was highest among Type 2 diabetes patients with 66.9% (95%CI: 60.3-73.1), followed by patients with coronary artery disease with 55.2% (95%CI: 50.8-59.6) and cardiovascular diseases with 48.3% (95%CI: 33.5-63.3) (P<0.001). With 33.6% (95% CI: 28.3-39.1), the southern African region was the most affected, followed by upper-middle income economies with 35% (95% CI: 29.5-40.6).
This study, regardless of the definition used, reveals a high prevalence of MS in Africa, confirming the ongoing epidemiological transition in African countries. Early prevention and treatment strategies are urgently needed to reverse this trend.
代谢综合征（MS）是全球范围内主要的死亡原因之一。多项研究发现，MS 在多个非洲地区普遍存在。然而，目前尚无针对非洲人群中 MS 患病率的具体估计。本研究旨在评估非洲人群中 MS 的总体患病率。
我们在 PubMed、Web of Science、Africa Index Medicus 和 African Journal Online Scopus 中进行了系统检索，以查找截至 2022 年 8 月 15 日发表的研究。根据六种诊断方法计算汇总患病率。采用随机效应模型估算 MS 的汇总患病率。我们的偏倚风险分析基于 Hoy 等人的工具。进行了异质性（I2）评估以及 Egger 检验以评估发表偏倚。将 PROSPERO 编号 CRD42021275176 分配给本研究。
共纳入了来自 29 个非洲国家的 297 项研究，共计 345 项患病率数据，涉及 156464 名参与者。非洲 MS 的总体患病率为 32.4%（95%CI：30.2-34.7），存在显著的异质性（I2=98.9%；P<0.001）。我们分别采用世界卫生组织（WHO）、修订后的 NCEP-ATP III、JIS、NCEP/ATP III 和 IDF 定义标准，获得了 44.8%（95%CI：24.8-65.7）、39.7%（95%CI：31.7-48.1）、33.1%（95%CI：28.5-37.8）、31.6%（95%CI：27.8-35.6）和 29.3%（95%CI：25.7-33）的患病率。与<18 岁的儿童（95%CI：7.3-20.6）相比，>18 岁的成年人（95%CI：30.8-35.5）MS 的患病率明显更高（P<0.001）。与男性（95%CI：23.1-30.5）相比，女性（95%CI：33.2-40.7）MS 的患病率明显更高（P<0.001）。与男性（95%CI：23.1-30.5）相比，女性（95%CI：33.2-40.7）MS 的患病率明显更高（P<0.001）。与男性（95%CI：23.1-30.5）相比，女性（95%CI：33.2-40.7）MS 的患病率明显更高（P<0.001）。与男性（95%CI：23.1-30.5）相比，女性（95%CI：33.2-40.7）MS 的患病率明显更高（P<0.001）。MS 患病率在 2 型糖尿病患者中最高，为 66.9%（95%CI：60.3-73.1），其次是冠心病患者为 55.2%（95%CI：50.8-59.6）和心血管疾病患者为 48.3%（95%CI：33.5-63.3）（P<0.001）。南部非洲地区（95%CI：28.3-39.1）的患病率最高，其次是中高收入经济体（95%CI：29.5-40.6）。
无论使用何种定义，本研究均表明非洲的 MS 患病率较高，证实了非洲国家正在经历的流行病学转变。迫切需要采取早期预防和治疗策略来扭转这一趋势。
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