Ballena-Caicedo Jhosmer, Zuzunaga-Montoya Fiorella E, Loayza-Castro Joan A, Bustamante-Rodríguez Juan Carlos, Vásquez Romero Luisa Erika Milagros, Tapia-Limonchi Rafael, De Carrillo Carmen Inés Gutierrez, Vera-Ponce Víctor Juan
Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Chachapoyas, Peru.
Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Chachapoyas, Peru.
Front Endocrinol (Lausanne). 2025 Aug 22;16:1646258. doi: 10.3389/fendo.2025.1646258. eCollection 2025.
To determine the global prevalence of IR, evaluating differences according to study designs and population characteristics.
A systematic review with meta-analysis was conducted. The search encompassed MEDLINE (PubMed), Scopus, Web of Science, and EMBASE, including observational studies that employed the HOMA-IR index to estimate IR and published adult prevalence data. Articles without clear IR definitions or with highly specific populations were excluded. The meta-analysis applied a random-effects model with proportion transformation (Freeman-Tukey), assessing heterogeneity with I² and Cochran's Q test. Additionally, a meta-regression by publication year was conducted.
Eighty-seven studies were included, with 235,148 participants. The pooled prevalence of IR was estimated at 26.53% (95% CI: 24.10-29.03; I²=99%), with no statistically significant differences when comparing probabilistic versus non-probabilistic sampling or when stratifying by sex. The meta-regression revealed no clear variations according to publication year or other explored factors.
This systematic review demonstrates that IR reaches a global prevalence of 26.53%, with estimated differences between 26% and 30% across different populations and geographical regions. Despite the diversity in cut-off points employed for HOMA-IR, no statistically significant differences were observed when comparing sampling designs or stratifying by sex. Furthermore, no clear trend related to publication year was evidenced.
确定胰岛素抵抗（IR）的全球患病率，根据研究设计和人群特征评估差异。
进行了一项系统评价和荟萃分析。检索范围包括MEDLINE（PubMed）、Scopus、科学网和EMBASE，纳入采用稳态模型评估胰岛素抵抗（HOMA-IR）指数估算IR并发表了成人患病率数据的观察性研究。排除无明确IR定义或人群高度特异的文章。荟萃分析采用比例变换的随机效应模型（Freeman-Tukey），用I²和Cochran's Q检验评估异质性。此外，按发表年份进行了荟萃回归分析。
纳入87项研究，共235,148名参与者。IR的合并患病率估计为26.53%（95%CI：24.10 - 29.03；I² = 99%），比较概率抽样与非概率抽样或按性别分层时，无统计学显著差异。荟萃回归分析显示，按发表年份或其他探索因素无明显差异。
本系统评价表明，IR的全球患病率为26.53%，不同人群和地理区域的估计患病率在26%至30%之间。尽管用于HOMA-IR的切点存在差异，但比较抽样设计或按性别分层时，未观察到统计学显著差异。此外，未发现与发表年份相关的明显趋势。
