The prevalence of metabolic syndrome is growing because of increasing rates of obesity and sedentary lifestyle. Metabolic syndrome is one of the most important risk factors associated with diabetes, cardiovascular disease, and all-cause mortality. Few studies have examined its sex-specific prevalence in China across time. We compared the prevalences and temporal trends of metabolic syndrome in Chinese women and men.

We conducted a PRISMA-compliant search in MEDLINE and Embase from their inception to Feb 15, 2018, for epidemiological studies that reported metabolic syndrome prevalence in Chinese individuals. We included data from population-based studies for individuals aged 15 years and older and a random effect model was used to estimate prevalence and 95% CI. We modelled within-study variability by binomial distribution and Freeman-Tukey double arcsine transformation to stabilise the variances. We did subgroup analyses by sex, age, region, and screening period.

We identified 80 eligible studies that included 734 511 individuals. The overall prevalence of metabolic syndrome in China was 22·0% (95% CI 19·9–24·1). Its prevalence was higher in women (23·6%, 21·0–26·3) than in men (21·0%, 18·8–23·3), in urban (23·5%, 20·7–26·) than in rural regions (20·3%, 16·4–24·6), and in people older than 40 years (27·6%, 23·9–31·6) than in those aged 15–40 years (8·3%, 6·5–10·3). From 1991–1995 to 2011–2015, prevalence of metabolic syndrome rose rapidly from 8·8% (2·8–17·7) to 29.3% (21·8–37·3), with a greater rise in women (from 7·9% to 30·7%) than in men (9·4% to 27·2%).

We found a rapidly increasing prevalence of metabolic syndrome in Chinese women. These findings suggest that more targeted lifestyle intervention and early screening programmes should be implemented for women in China.

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