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Association Between Anthropometric Risk Factors and Metabolic Syndrome Among Adults in India: A Systematic Review and Meta-Analysis of Observational Studies

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A flow chart describes the selection process for the 26 studies included in the systematic review. Of the 3,325 articles initially identified, 26 studies with a total of 37,965 participants met eligibility criteria.


Figure 1.

Flowchart describing the selection process for the 26 studies (16–41) included in the systematic review of studies on the association between anthropometric risk factors and metabolic syndrome among adults in India.

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Figure 2.

Forest plot showing the association of overweight (BMI ≥23–≥25) with metabolic syndrome among adults in India based on a systematic review of 15 studies (16–21,28,29,31,32,35–37,39,40). The definition of overweight varies among studies. Weights are from a random-effects model. The gray boxes around the point estimates indicate the preciseness of the estimate, the larger the box, the more precise the estimate (the narrower the CI).

Forest plot showing the association of overweight (BMI ≥23–≥25) with metabolic syndrome among adults in India based on a systematic review of 15 studies (16–21,28,29,31,32,35–37,39,40). The definition of overweight varies among studies. Weights are from a random-effects model. The gray boxes around the point estimates indicate the preciseness of the estimate, the larger the box, the more precise the estimate (the narrower the CI).
Study, year Odds ratio (95% CI) Weighted %
Barik et al, 2018 (16) 4.33 (3.85–4.88) 8.66
Bhagat et al, 2017 (17) 2.83 (1.85–4.31) 7.92
Bhattacharya et al, 2016 (18) 8.97 (3.78–21.28) 6.12
Deedwania et al, 2014 (19) 1.53 (1.36–1.72) 8.66
Jamkhandi et al, 2019 (20) 12.20 (4.20–35.46) 5.29
Kunti et al, 2019 (21) 2.15 (1.30–3.57) 7.62
Lakshmipriya et al, 2012 (28) 6.32 (4.95–8.08) 8.44
Majumdar et al, 2017 (29) 11.16 (2.40–51.94) 3.72
Manjunath et al, 2014 (31) 87.71 (11.82–651.14) 2.65
Misra et al, 2011 (32) 17.55 (5.12–60.22) 4.68
Sharma et al, 2016 (35) 5.62 (3.27–9.66) 7.48
Sinha et al, 2016 (36) 8.97 (3.78–21.28) 6.12
Srinivasan et al, 2016 (37) 3.67 (2.70–4.98) 8.28
Thayyil et al, 2012 (39) 3.68 (2.23–6.05) 7.65
Vembu et al, 2019 (40) 10.74 (5.20–22.21) 6.71
Overall, I2 = 94.5%, P < .001 5.47 (3.70–8.09) 100.00

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Figure 3.

Forest plot showing the association of obesity with metabolic syndrome among adults in India, as reported in 21 studies (17–23,25–28,30–35,37,38,40,41). The definition of obesity varies among studies. Weights are from a random-effects model; continuity connection was applied to studies with zero cells. The gray boxes around the point estimates indicate the preciseness of the estimate, the larger the box, the more precise the estimate (the narrower the CI).

Forest plot showing the association of obesity with metabolic syndrome among adults in India, as reported in 21 studies (17–23,25–28,30–35,37,38,40,41). The definition of obesity varies among studies. Weights are from a random-effects model; continuity connection was applied to studies with zero cells. The gray boxes around the point estimates indicate the preciseness of the estimate, the larger the box, the more precise the estimate (the narrower the CI).
Study, year Odds ratio (95%CI) Weighted %
Bhagat et al, 2017 (17) 2.69 (1.67–4.36) 5.10
Bhattacharya et al, 2016 (18) 9.30 (2.89–29.90) 3.31
Deedwania et al, 2014 (19) 1.68 (1.51–1.86) 5.70
Goyal et al, 2013 (20) 196.65 (12.08–3200.50) 1.10
Gupta R et al, 2004 (21) 7.43 (5.53–9.97) 5.48
Harikrishnan et al, 2018 (22) 3.64 (3.21–4.13) 5.68
Ismail et al, 2016 (23) 7.17 (1.73–29.69) 2.75
Kapil et al, 2018 (25) 35.54 (23.26–54.30) 5.23
Kaur et al, 2014 (26) 0.99 (0.47–2.08) 4.41
Kunti et al, 2019 (27) 1.58 (1.01–2.49) 5.16
Lakshmipriya et al, 2012 (28) 4.70 (3.79–5.82) 5.59
Mangat et al, 2010 (30) 12.68 (8.58–18.76) 5.29
Manjunath et al, 2014 (31) 29.75 (10.13–87.38) 3.53
Misra et al, 2011 (32) 10.06 (4.19–24.13) 4.06
Prasad et al, 2012 (33) 5.73 (4.45–7.38) 5.54
Selvaraj et al, 2019 (34) 2.21 (1.25–3.93) 4.87
Sharma et al, 2016 (35) 3.00 (1.92–4.71) 5.17
Srinivasan et al, 2016 (37) 3.87 (2.86–5.24) 5.46
Tharkar et al, 2010 (38) 3.05 (2.48–3.75) 5.60
Vembu et al, 2019 (40) 4.32 (3.13–5.97) 5.43
Zafar et al, 2017 (41) 7.04 (5.50–9.00) 5.55
Overall, I2 = 95.9%, P < .001 5.00 (3.61–6.93) 100.00

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