Metabolic syndrome affects 21.3% of Nepalese adults but extreme heterogeneity limits national estimatesNew data reveals high rates of metabolic syndrome in Nepal

medRxiv Published September 12, 2026 Study authors: Pandey, S.; Tiwari, A.; Bhattarai, A.; Timalsina, A.; Khatiwada, P.; Pandey, A.; Basnet, A.; Neupane… DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Interpret metabolic syndrome prevalence cautiously due to extreme heterogeneity.

This meta-analysis pooled data from studies of 21,708 Nepalese adults to estimate the prevalence of metabolic syndrome and its individual components. The overall pooled prevalence of metabolic syndrome was 21.3% (95% CI: 11.6-35.9%). Among individual components, low HDL was most common at 64.5%, followed by abdominal obesity at 59.5% and hypertriglyceridemia at 47.0%.

Heterogeneity was extreme, with an I^2 of 99.4%. The 95% prediction interval ranged from 2.0% to 78.6%, indicating that prevalence in any single setting could vary widely from the pooled estimate. The authors explicitly caution that national averages are misleading due to this heterogeneity.

GRADE certainty was very low for the overall prevalence estimate, but low to moderate for individual components. No safety data, follow-up duration, or comparator were reported, consistent with the prevalence-based scope of the review.

The authors conclude that public health strategies should prioritize local data and address widespread dyslipidemia and obesity. Clinicians should interpret the pooled estimate with caution given the extreme between-study heterogeneity and very low certainty for the overall prevalence figure.

How this fits prior evidence

This meta-analysis extends prior coverage of metabolic syndrome by providing pooled prevalence data specific to Nepalese adults, complementing the global burden estimate from the Balanced-Pareto food reallocation analysis. It also aligns with prior findings on Tai Chi improving blood pressure and atherogenic lipid markers in older women, reinforcing that dyslipidemia and hypertension are modifiable components. However, the extreme heterogeneity (I^2 = 99.4%) and very low GRADE certainty for overall prevalence contrast with the more precise effect estimates reported for diabetes-specific nutritional formulas and Tai Chi interventions, highlighting a gap in reliable local prevalence data.

Living with metabolic syndrome means dealing with a group of health risks at once, including high blood pressure, high blood sugar, and issues with blood fats. A large study of over 21,000 adults in Nepal found that 21.3% of the population meets the criteria for this condition. While that is the national average, the researchers noted that individual experiences can vary significantly across different regions.

Beyond the overall rate, the study looked at specific risk factors. Many people in the group showed signs of abdominal obesity (59.5%) and low HDL, which is a type of good cholesterol (64.5%). Nearly half of the people studied also had hypertriglyceridemia, which is a high level of certain fats in the blood.

Because the data showed a lot of variation between different groups, the researchers warn that a single national average doesn't tell the whole story for everyone. The evidence for the overall rate is considered low certainty, but the data for specific issues like obesity and blood fats is more reliable. These findings suggest that local health plans need to focus on these specific risks to help people manage their health better.

What this means for you:

Over 20% of adults in Nepal have metabolic syndrome, with high rates of obesity and high blood fats.

Common questions

What is metabolic syndrome?

Metabolic syndrome is a group of conditions that increase your risk of heart disease and diabetes. It includes having high blood pressure, high blood sugar, and high levels of certain fats in your blood. The study found that 21.3% of adults in Nepal have this combination of risk factors.

What specific risk factors were found in the study?

The study found several specific issues among the 21,708 adults. These included abdominal obesity at 59.5%, low HDL (good cholesterol) at 64.5%, and hypertriglyceridemia (high blood fats) at 47.0%.

Is the 21.3% average accurate for everyone in Nepal?

The researchers noted that the national average can be misleading because of high variation in the data. While the overall average is 21.3%, individual results can vary greatly depending on the specific local area or group.

Study Details

Study typeMeta analysis

Sample sizen = 100

EvidenceLevel 1

PublishedSep 2026

View Original Abstract ↓

Background: Metabolic syndrome is a cluster of cardiometabolic risk factors including abdominal obesity, dyslipidemia, hypertension, and hyperglycemia. Its prevalence in Nepal has been reported inconsistently, with figures ranging from very low to extremely high. Reliable evidence is needed to inform policy and prevention strategies. Methods: We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of Metabolic syndrome among Nepalese adults. Databases searched included PubMed, Embase, Scopus, and Nepalese journals up to May 2025. Eligible studies used recognized diagnostic criteria, enrolled [≥]100 participants, and were assessed for quality using the modified Newcastle-Ottawa Scale. The primary analysis employed a binomial generalized linear mixed model (GLMM). Heterogeneity was quantified using I^2 and {tau}^2, and 95% prediction intervals were emphasized. Subgroup, sensitivity, and leave-one-out analyses were performed. Certainty of evidence was evaluated using GRADE. Results: Eight studies comprising 21,708 participants were included. The pooled prevalence of Metabolic Syndrome was 21.3% (95% CI: 11.6-35.9%), but heterogeneity was extreme (I^2 = 99.4%). The 95% PI indicated that true prevalence in new populations could range from 2.0% to 78.6%. Subgroup analysis by setting (urban vs. mixed) did not explain the variability. Component analysis revealed high prevalence of low HDL (64.5%), abdominal obesity (59.5%), and hypertriglyceridemia (47.0%). GRADE certainty was very low for overall prevalence, but low to moderate for individual components. Conclusions: Metabolic syndrome represents a significant but unevenly distributed burden in Nepal. The extreme heterogeneity underscores that national averages are misleading. Public health strategies should prioritize local data and address widespread dyslipidemia and obesity while future research must clarify the determinants of disparity.

Metabolic syndrome affects 21.3% of Nepalese adults but extreme heterogeneity limits national estimatesNew data reveals high rates of metabolic syndrome in Nepal

How this fits prior evidence

Common questions

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Metabolic syndrome affects 21.3% of Nepalese adults but extreme heterogeneity limits national estimatesNew data reveals high rates of metabolic syndrome in Nepal

How this fits prior evidence

Common questions

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