Abstract：
OBJECTIVE: The prevalence of metabolic syndrome (MetS) is on the rise in an increasingly urbanized world. The study aimed to review the association between urbanization and MetS in low- and middle-income countries (LMICs).
RESULTS: A comprehensive search of five databases (MEDLINE, Web of Science, Scopus, EMBASE, and CENTRAL) was performed in January 2022 and updated in October 2022. Peer-reviewed studies that met the eligibility selection criteria were included. Search terms were used for the main concepts which are MetS, dietary patterns, and urbanization in LMICs. Study selection was done in two stages and in duplicate. Random effects models were used to calculate the overall pooled prevalence and main study-level characteristics. Out of 9,773 identified studies, nineteen were included in the systematic review and meta-analysis. The studies were done on 313,644 participants (149,616 urban and 164,028 rural). The pooled risk ratio (RR, 95% confidence interval) of MetS between urban and rural dwellers was RR = 1.24; 95%CI [1.15, 1.34] (I2 = 96.0%, P < 0.0001). A relatively higher prevalence of MetS among urban than rural residents has been observed, especially with the International Diabetes Federation criteria (RR = 1.54; 95%CI [1.21, 1.96]; I2 = 65.0%), and in the population in India (RR = 2.19; 95%CI = 1.24, 3.88, I2 = 85%). Overall, the role of dietary patterns in the development of MetS was inconsistent, and few studies showed a lower risk of MetS with adherence to recommended healthy dietary patterns.
CONCLUSIONS: There was an association between urbanization and the high prevalence of MetS. Interventions and policies to reduce the risk of MetS are needed.
RESULTS: A comprehensive search of five databases (MEDLINE, Web of Science, Scopus, EMBASE, and CENTRAL) was performed in January 2022 and updated in October 2022. Peer-reviewed studies that met the eligibility selection criteria were included. Search terms were used for the main concepts which are MetS, dietary patterns, and urbanization in LMICs. Study selection was done in two stages and in duplicate. Random effects models were used to calculate the overall pooled prevalence and main study-level characteristics. Out of 9,773 identified studies, nineteen were included in the systematic review and meta-analysis. The studies were done on 313,644 participants (149,616 urban and 164,028 rural). The pooled risk ratio (RR, 95% confidence interval) of MetS between urban and rural dwellers was RR = 1.24; 95%CI [1.15, 1.34] (I2 = 96.0%, P < 0.0001). A relatively higher prevalence of MetS among urban than rural residents has been observed, especially with the International Diabetes Federation criteria (RR = 1.54; 95%CI [1.21, 1.96]; I2 = 65.0%), and in the population in India (RR = 2.19; 95%CI = 1.24, 3.88, I2 = 85%). Overall, the role of dietary patterns in the development of MetS was inconsistent, and few studies showed a lower risk of MetS with adherence to recommended healthy dietary patterns.
CONCLUSIONS: There was an association between urbanization and the high prevalence of MetS. Interventions and policies to reduce the risk of MetS are needed.
摘要：
目的：在日益城市化的世界中，代谢综合征（MetS）的患病率正在上升。该研究旨在审查城市化与中低收入国家（LMICs）之间的关系。
结果：对五个数据库的全面搜索（MEDLINE，WebofScience,Scopus,EMBASE,和CENTRAL）于2022年1月进行，并于2022年10月更新。纳入符合资格选择标准的同行评审研究。搜索术语用于MetS的主要概念，饮食模式，和低收入国家的城市化。研究选择分两个阶段进行，一式两份。随机效应模型用于计算总体汇总患病率和主要研究水平特征。在9,773项确定的研究中，19例纳入系统评价和荟萃分析.这项研究是针对313,644名参与者（149,616名城市和164,028名农村）进行的。合并风险比(RR，城乡居民之间的95%置信区间)为RR=1.24；95CI[1.15，1.34](I2=96.0%，P<0.0001)。已经观察到，城市居民中的MetS患病率相对高于农村居民，特别是国际糖尿病联合会标准（RR=1.54;95CI[1.21,1.96];I2=65.0%），在印度人口中（RR=2.19；95CI=1.24，3.88，I2=85％）。总的来说,饮食模式在MetS发展中的作用是不一致的，很少有研究表明，在遵守推荐的健康饮食模式的情况下，MetS的风险较低。
结论：城市化与MetS的高患病率之间存在关联。需要采取干预措施和政策来降低MetS的风险。
结果：对五个数据库的全面搜索（MEDLINE，WebofScience,Scopus,EMBASE,和CENTRAL）于2022年1月进行，并于2022年10月更新。纳入符合资格选择标准的同行评审研究。搜索术语用于MetS的主要概念，饮食模式，和低收入国家的城市化。研究选择分两个阶段进行，一式两份。随机效应模型用于计算总体汇总患病率和主要研究水平特征。在9,773项确定的研究中，19例纳入系统评价和荟萃分析.这项研究是针对313,644名参与者（149,616名城市和164,028名农村）进行的。合并风险比(RR，城乡居民之间的95%置信区间)为RR=1.24；95CI[1.15，1.34](I2=96.0%，P<0.0001)。已经观察到，城市居民中的MetS患病率相对高于农村居民，特别是国际糖尿病联合会标准（RR=1.54;95CI[1.21,1.96];I2=65.0%），在印度人口中（RR=2.19；95CI=1.24，3.88，I2=85％）。总的来说,饮食模式在MetS发展中的作用是不一致的，很少有研究表明，在遵守推荐的健康饮食模式的情况下，MetS的风险较低。
结论：城市化与MetS的高患病率之间存在关联。需要采取干预措施和政策来降低MetS的风险。
