Metabolic syndrome and its components in people with intellectual disability : a meta-analysis

Background: People with intellectual disability have an increased risk for cardiovascular diseases and associated premature mortality. Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The aim of this meta-analysis was to describe the pooled prevalence of MetS and its components in people with intellectual disability taking into account variations in demographic, clinical and treatment-related variables. Methods Pubmed, Embase and CINAHL were searched until 5 August 2020 for studies reporting cross-sectional data on prevalences of MetS and its components in people with intellectual disability. Two independent reviewers extracted data. Random effects meta-analyses with subgroup and meta-regression analyses were employed. Results: The pooled MetS prevalence after adjusting for publication bias was 22.5% [95% confidence interval (CI) = 16.8%-29.6%; N studies = 10; n participants = 2443, median age at study level = 38.5 years; 52% male]. Abdominal obesity was observed in 52.0% (95% CI = 42.0%-61.9%; I2 = 86.5; N = 5; n = 844), hypertension in 36.7% (95% CI = 26.1%-48.7%; N = 6; n = 926), hypertriglyceridaemia in 23.5% (95% CI = 18.8%- 28.9%; N = 5; n = 845), low high-density-lipoprotein-cholesterol in 23.4% (95% CI = 19.3%-28.0%; N = 6; n = 917), and hyperglycaemia in 10.2% (95% CI = 7.6%-13.3%; N = 5; n = 845). Meta-regression revealed that a higher MetS frequency was moderated by older age (coefficient = 0.03; standard error = 0.01, 95% CI = 0.008 to 0.055; N = 19; n = 2443) and a higher proportion of people on antidepressants in the study (coefficient = 7.24; standard error = 0.90, 95% CI = 5.48-9.00; N = 4; n = 546). There were insufficient data comparing MetS in people with intellectual disability with age-matched and gender-matched controls. Conclusions Considering that more than one fifth of people with intellectual disability have MetS, routine screening and multidisciplinary management of metabolic abnormalities in people with intellectual disability is needed. Attention should be given to older people and those on antidepressants.