Mekonnen Chilot Kassa, Abate Hailemichael Kindie, Azagew Abere Woretaw, Zegeye Alebachew Ferede
Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O. BOX 196, Gondar City, Ethiopia.
BMC Public Health. 2025 Jan 10;25(1):121. doi: 10.1186/s12889-025-21315-4.
Metabolic syndrome has become a major public health problem worldwide and is attributable to the spread of different non-communicable diseases such as type 2 diabetes mellitus, coronary artery diseases, stroke, and permanent or temporary disabilities. It is not a single disease entity but encompasses different risk factors. However, there were inconsistencies among previously conducted primary studies, hence this systematic review and meta-analysis aimed to determine the pooled prevalence and determinants of metabolic syndrome among type2 diabetes patients in Ethiopia.
First-hand studies about the metabolic syndrome among adult type 2 diabetic patients in Ethiopia were searched through known and international databases (PubMed, Scopus, Web of Science, and Cochran Library) and search engines (Google and Google Scholar). Data was extracted using a standard data extraction checklist developed according to Joanna Briggs Institute (JBI). The I statistics are used to identify heterogeneity across studies. Funnel plot asymmetry and Egger's tests were used to check for publication bias. A random effect model was used to estimate the pooled prevalence of the metabolic syndrome among non-insulin-dependent patients in Ethiopia. The STATA version 11 software employed for statistical analysis was conducted using STATA version 11 software.
The overall pooled prevalence of metabolic syndrome among type2 diabetic patients in was 54.56% [95%CI (43.73, 65.38), I = 97.0%, P = 0.001] using NCEP-ATP III, 48.32% [95%CI (42.1, 54.44), I = 97.0%, P = 0.001] IDF diagnosis criteria, 47.0[95%CI(27.01-66.99)], I = 97.5%, p = 0.001 using WHO and 59.37%(95%CI(47.21-71.52), I = 91.2%, p = 0.001 using harmonized diagnosis criteria respectively. This meta-analysis identified several significant predictors of metabolic syndrome among type 2 diabetes patients in Ethiopia. The odds of having metabolic syndrome was reduced for females (Adjusted Odds Ratio [AOR] = 0.55, 95% CI: 0.35-0.87) compared to males. However, the odds of metabolic syndrome increased with alcohol intake (AOR = 1.44, 95% CI: 1.03-2.01), the odds of living in urban areas(AOR = 2.12, 95% CI: 1.55-2.88), and the odds of having a diabetes duration of six or more years since diagnosis (AOR = 2.94, 95% CI: 1.17-7.41) were significant predictors.
The pooled prevalence was considerably high among type 2 diabetic patients in Ethiopia. The pooled prevalence of metabolic syndrome varies as per the diagnosis criteria used with the highest observed in harmonized diagnosis criteria. Being female, being rural residency, alcohol intake, and duration of diabetes since diagnosis were significant predictors of metabolic syndrome among type 2 diabetic patients in Ethiopia.
代谢综合征已成为全球主要的公共卫生问题，可归因于不同非传染性疾病的传播，如2型糖尿病、冠状动脉疾病、中风以及永久性或暂时性残疾。它不是单一的疾病实体，而是包含不同的危险因素。然而，先前进行的初步研究存在不一致之处，因此本系统评价和荟萃分析旨在确定埃塞俄比亚2型糖尿病患者中代谢综合征的合并患病率及其决定因素。
通过知名国际数据库（PubMed、Scopus、科学网和考克兰图书馆）以及搜索引擎（谷歌和谷歌学术）检索关于埃塞俄比亚成年2型糖尿病患者代谢综合征的一手研究。使用根据乔安娜·布里格斯研究所（JBI）制定的标准数据提取清单提取数据。I统计量用于识别各研究之间的异质性。漏斗图不对称性和埃格检验用于检查发表偏倚。采用随机效应模型估计埃塞俄比亚非胰岛素依赖型患者中代谢综合征的合并患病率。使用STATA 11版软件进行统计分析。
使用美国国家胆固醇教育计划成人治疗组第三次报告（NCEP-ATP III）标准时，埃塞俄比亚2型糖尿病患者中代谢综合征的总体合并患病率为54.56%[95%置信区间（CI）（43.73，65.38），I = 97.0%，P = 0.001]；使用国际糖尿病联盟（IDF）诊断标准时为48.32%[95%CI（42.1，54.44），I = 97.0%，P = 0.001]；使用世界卫生组织（WHO）标准时为47.0[95%CI（27.01 - 66.99）]，I = 97.5%，P = 0.001；使用统一诊断标准时为59.37%（95%CI（47.21 - 71.52）），I = 91.2%，P = 0.001。该荟萃分析确定了埃塞俄比亚2型糖尿病患者中代谢综合征的几个重要预测因素。与男性相比，女性患代谢综合征的几率降低（调整优势比[AOR] = 0.55，95%CI：0.35 - 0.87）。然而，代谢综合征的几率随着饮酒量增加（AOR = 1.44，95%CI：1.03 - 2.01）、居住在城市地区（AOR = 2.12，95%CI：1.55 - 2.88）以及自诊断以来糖尿病病程达六年或更长时间（AOR = 2.94，95%CI：1.17 - 7.41）而增加，这些都是显著的预测因素。
埃塞俄比亚相当比例的2型糖尿病患者合并患病率很高。代谢综合征的合并患病率因所使用的诊断标准而异，统一诊断标准下观察到的患病率最高。女性、农村居民身份、饮酒量以及自诊断以来的糖尿病病程是埃塞俄比亚2型糖尿病患者中代谢综合征的重要预测因素。
