Global prevalence and associated factors of metabolic syndrome in patients with systemic lupus erythematosus: A systematic review and meta-analysis
Abstract
BackgroundSystemic lupus erythematosus (SLE) is characterized by chronic systemic inflammation, frequent corticosteroid exposure, and heightened cardiometabolic vulnerability. Metabolic syndrome (MetS) has become a clinically significant comorbidity among individuals with SLE. We performed an updated systematic review and meta-analysis to better understand the prevalence and identify the factors associated with the occurrence of MetS in SLE.MethodsPubMed, Scopus, and Web of Science were systematically searched through January 4, 2026 to identify observational studies reporting the prevalence of MetS among individuals with SLE. Random-effects meta-analytic models were applied to calculate pooled prevalence estimates and evaluate the associations with potential risk factors.ResultsThe overall pooled prevalence of MetS in patients with SLE was estimated at 0.27 (95% CI: 0.24-0.30). Sex-stratified analyses showed a prevalence of 0.36 (95% CI: 0.25-0.47) in male patients and 0.27 (95% CI: 0.23-0.30) in female patients. Across continents, the highest prevalence was observed in Africa (0.36, 95% CI: 0.30-0.41), followed by South America (0.32, 95% CI: 0.24-0.40), Asia (0.27, 95% CI: 0.22-0.32), Europe (0.23, 95% CI: 0.18-0.28), and North America (0.21, 95% CI: 0.14-0.30). Regarding medication use, hydroxychloroquine was associated with a significantly reduced risk of MetS (OR = 0.66, 95% CI: 0.52-0.83; P < 0.01), whereas cyclophosphamide (OR = 1.39, 95% CI: 1.06-1.81; P = 0.02),…
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