Prevalence of metabolic syndrome in ankylosing spondylitis: a multi national meta-analysis study
Abstract Background Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with an increased risk of metabolic syndrome (MetS), a cluster of cardiometabolic risk factors. However, the prevalence of MetS in AS remains uncertain. This meta-analysis estimates the global prevalence of...
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BMC
2025-05-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01720-w |
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| author | Sandeep Samethadka Nayak Kwame Boateng Agyeman Khushbu Viresh Janani Maryam Jafari Mohammad Amouzadeh Lichahi Pubali Biswas Mohammad Hashemi Nimra Shafi Yasmin Sahli Ehsan Amini-Salehi Narsimha Rao Keetha |
| author_facet | Sandeep Samethadka Nayak Kwame Boateng Agyeman Khushbu Viresh Janani Maryam Jafari Mohammad Amouzadeh Lichahi Pubali Biswas Mohammad Hashemi Nimra Shafi Yasmin Sahli Ehsan Amini-Salehi Narsimha Rao Keetha |
| author_sort | Sandeep Samethadka Nayak |
| collection | DOAJ |
| description | Abstract Background Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with an increased risk of metabolic syndrome (MetS), a cluster of cardiometabolic risk factors. However, the prevalence of MetS in AS remains uncertain. This meta-analysis estimates the global prevalence of MetS in AS patients and identifies factors contributing to its variability. Methods A systematic search of PubMed, Scopus, Embase, and Web of Science was conducted for studies published up to January 18, 2024. A random-effects model was used to estimate pooled prevalence, while meta-regression and subgroup analyses explored sources of heterogeneity. Results Seventeen studies meeting the eligibility criteria were included. The pooled prevalence of MetS in AS patients was 15.5% (95% confidence interval [CI]: 10.9–20.8%). The highest prevalence was reported in Africa (37.0%) and the lowest in Asia (8.0%). Variability in AS diagnostic criteria influenced prevalence estimates, with the highest MetS rates found in studies using the Assessment of SpondyloArthritis International Society (ASAS) criteria (37.0%). Meta-regression identified significant associations between MetS prevalence and older age (β = 0.04, P < 0.01), higher body mass index (β = 0.09, P < 0.01), triglyceride levels (β = 0.01, P < 0.01), waist circumference (β = 0.03, P < 0.01), diastolic blood pressure (β = 0.04, P = 0.02) and disease activity, measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (β = 0.03, P = 0.02). Erythrocyte sedimentation rate was significantly correlated with MetS prevalence (β = 0.01, P = 0.04), while C-reactive protein was not (β = -0.01, P = 0.12). Conclusion MetS is a prevalent comorbidity in AS, significantly influenced by inflammation, obesity, and disease activity. Given its strong association with cardiovascular risk, routine metabolic screening should be incorporated into AS management. Clinicians should adopt an integrated approach that includes lifestyle modifications, targeted therapies, and careful cardiovascular risk assessment to mitigate long-term complications. Standardized diagnostic criteria for MetS in AS are needed to improve risk stratification and patient outcomes. |
| format | Article |
| id | doaj-art-bc0d403f2abe493f89ebc2e7f22a40bc |
| institution | OA Journals |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-bc0d403f2abe493f89ebc2e7f22a40bc2025-08-20T02:25:11ZengBMCDiabetology & Metabolic Syndrome1758-59962025-05-0117111410.1186/s13098-025-01720-wPrevalence of metabolic syndrome in ankylosing spondylitis: a multi national meta-analysis studySandeep Samethadka Nayak0Kwame Boateng Agyeman1Khushbu Viresh Janani2Maryam Jafari3Mohammad Amouzadeh Lichahi4Pubali Biswas5Mohammad Hashemi6Nimra Shafi7Yasmin Sahli8Ehsan Amini-Salehi9Narsimha Rao Keetha10Division of Hospital Medicine, Department of Internal Medicine, Yale New Heaven Health| Bridgeport HospitalDivision of General Medicine, Department of Medicine, Loma Linda University HealthDepartment of Internal Medicine, Soundview Medical Associates, Hartford HealthcareStudent Research Committee, Anzali International Campus, Guilan University of Medical SciencesStudent Research Committee, Anzali International Campus, Guilan University of Medical SciencesVydehi Institute of Medical Sciences and Research CentreCardiovascular Research Center, Hormozgan University of Medical SciencesDepartment of Medicine, Arnot Ogden Medical CenterYale New Haven HospitalSchool of Medicine, Guilan University of Medical SciencesOhio Kidney and Hypertension CenterAbstract Background Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with an increased risk of metabolic syndrome (MetS), a cluster of cardiometabolic risk factors. However, the prevalence of MetS in AS remains uncertain. This meta-analysis estimates the global prevalence of MetS in AS patients and identifies factors contributing to its variability. Methods A systematic search of PubMed, Scopus, Embase, and Web of Science was conducted for studies published up to January 18, 2024. A random-effects model was used to estimate pooled prevalence, while meta-regression and subgroup analyses explored sources of heterogeneity. Results Seventeen studies meeting the eligibility criteria were included. The pooled prevalence of MetS in AS patients was 15.5% (95% confidence interval [CI]: 10.9–20.8%). The highest prevalence was reported in Africa (37.0%) and the lowest in Asia (8.0%). Variability in AS diagnostic criteria influenced prevalence estimates, with the highest MetS rates found in studies using the Assessment of SpondyloArthritis International Society (ASAS) criteria (37.0%). Meta-regression identified significant associations between MetS prevalence and older age (β = 0.04, P < 0.01), higher body mass index (β = 0.09, P < 0.01), triglyceride levels (β = 0.01, P < 0.01), waist circumference (β = 0.03, P < 0.01), diastolic blood pressure (β = 0.04, P = 0.02) and disease activity, measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (β = 0.03, P = 0.02). Erythrocyte sedimentation rate was significantly correlated with MetS prevalence (β = 0.01, P = 0.04), while C-reactive protein was not (β = -0.01, P = 0.12). Conclusion MetS is a prevalent comorbidity in AS, significantly influenced by inflammation, obesity, and disease activity. Given its strong association with cardiovascular risk, routine metabolic screening should be incorporated into AS management. Clinicians should adopt an integrated approach that includes lifestyle modifications, targeted therapies, and careful cardiovascular risk assessment to mitigate long-term complications. Standardized diagnostic criteria for MetS in AS are needed to improve risk stratification and patient outcomes.https://doi.org/10.1186/s13098-025-01720-wAnkylosing spondylitisMetabolic syndromePrevalenceCardiovascular riskInflammationObesity |
| spellingShingle | Sandeep Samethadka Nayak Kwame Boateng Agyeman Khushbu Viresh Janani Maryam Jafari Mohammad Amouzadeh Lichahi Pubali Biswas Mohammad Hashemi Nimra Shafi Yasmin Sahli Ehsan Amini-Salehi Narsimha Rao Keetha Prevalence of metabolic syndrome in ankylosing spondylitis: a multi national meta-analysis study Diabetology & Metabolic Syndrome Ankylosing spondylitis Metabolic syndrome Prevalence Cardiovascular risk Inflammation Obesity |
| title | Prevalence of metabolic syndrome in ankylosing spondylitis: a multi national meta-analysis study |
| title_full | Prevalence of metabolic syndrome in ankylosing spondylitis: a multi national meta-analysis study |
| title_fullStr | Prevalence of metabolic syndrome in ankylosing spondylitis: a multi national meta-analysis study |
| title_full_unstemmed | Prevalence of metabolic syndrome in ankylosing spondylitis: a multi national meta-analysis study |
| title_short | Prevalence of metabolic syndrome in ankylosing spondylitis: a multi national meta-analysis study |
| title_sort | prevalence of metabolic syndrome in ankylosing spondylitis a multi national meta analysis study |
| topic | Ankylosing spondylitis Metabolic syndrome Prevalence Cardiovascular risk Inflammation Obesity |
| url | https://doi.org/10.1186/s13098-025-01720-w |
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