Risk factors associated with metabolic syndrome in Vietnam and implications forprevention and control: A systematic review and Meta-Analysis

Tóm tắt

Objectives: To identify the major risk factors for metabolic syndrome in Vietnam and to assess their implications for future prevention and control efforts.
Method: We conducted a systematic review and meta-analysis of observational studies reporting metabolic syndrome and factors associated with its occurrence in Vietnamese populations. PubMed/MEDLINE, Web of Science Core Collection, Scopus, and Embase were searched through April 2026. Two reviewers independently screened records, extracted data, and assessed risk of bias using design-specific Joanna Briggs Institute tools. We distinguished a priori between upstream determinants outside the diagnostic definition of metabolic syndrome and clinical/metabolic abnormalities that overlap with its diagnostic components. Random-effects meta-analysis was completed for harmonised determinants with at least two sufficiently comparable study-level estimates, using log-transformed ORs/HRs and prioritising the most fully adjusted estimate from each study.
Results: Of 1,452 records identified, 1,037 remained after duplicate removal; 109 underwent full-text review; 34 studies met inclusion criteria (28 cross-sectional, 4 cohort, 2 case-control). Quantitative pooling was feasible for five upstream determinants. The pooled relative effect for BMI was 1.27 per 1 kg/m² (95% CI 1.18–1.36; I²=76.6%; k=2), reaching statistical significance. Pooled estimates for age (per 1-year increase: 1.04; 95% CI 0.996–1.09; k=2), urban residence (1.80; 95% CI 0.94–3.47; k=2), female sex (1.38; 95% CI 0.75–2.52; k=3), and current vs never/former smoking (0.73; 95% CI 0.51–1.04; k=3) were directionally consistent but imprecise, with confidence intervals crossing the null and substantial heterogeneity (I² 54–94%). Low physical activity and abdominal obesity remained narratively important, but exact pooled synthesis was not possible because only one comparable adjusted estimate was available for each determinant.
Conclusion: The currently harmonised evidence suggests that higher BMI was the most consistent pooled upstream determinant of metabolic syndrome in Vietnam, while age, urban residence, female sex, and smoking showed more heterogeneous summary associations. Low physical activity and abdominal adiposity remained important narrative determinants. Hypertension, dyslipidaemia, and glucose-related abnormalities were interpreted as component-level features of the metabolic syndrome phenotype rather than pooled etiologic predictors. Findings should be interpreted with caution given the small number of pooled studies (k=2–3) and the pooling of ORs from cross-sectional studies with HRs from cohort studies on the log scale. Future prevention and control efforts should prioritise weight management, physical activity promotion, early detection of central obesity and metabolic abnormalities, and risk-stratified screening in high-risk groups.