Background: The metabolic syndrome is a clustering of hyperglycemia/insulin resistance, hypertension, dyslipidemia and obesity which are risk factors for cardiovascular disease, type 2 diabetes, stroke and all-cause mortality. The burden of metabolic is emerging alarmingly in low-and middle income countries like Ethiopia. The aim of this study was to determine the pooled prevalence of metabolic syndrome and its components among the Ethiopian population of various study groups.

Methods: This systematic review and meta-analysis included original articles of observational studies published in English language. Searches were carried out in PubMed, Google Scholar, and Africa Journals from conception to April 2018. A Random-effect model was used to estimate the pooled prevalence of metabolic syndrome in Ethiopia. Heterogeneity was assessed using I² statistic. Sub-group analysis was also conducted based on sex, geographical region, study groups, and methodological differences.  Funnel plots and egger’s test were used to see publication bias.

Results: Electronic and grey literature search retrieved 331 potentially relevant papers. After removing duplicates, fourteen cross-sectional studies were included in this meta-analysis. The overall pooled prevalence of metabolic syndrome in Ethiopia was 29.32%. It was found 31.94% and 25.34% by using NCEP-ATP III and IDF criteria, respectively. Weighted pooled prevalence of metabolic syndrome was higher in females (34.84%) compared to males (17.74%). Sub-group analysis based on the study groups showed that the weighted pooled prevalence was 59.10%, 42.70, 21.28% and 15.65% among type 2 diabetes patients, hypertensive patients, HIV patients on HAART, and working adults, respectively. The most frequent metabolic syndrome components were low HDL-cholesterol (52.51%) and elevated triglycerides (41.94%).

Conclusions:  The findings revealed an emerging high prevalence of metabolic syndrome in Ethiopia in different class of population. Therefore, early intervention is required for the primary prevention of the occurrence of metabolic syndrome and for the further reduction of the morbidity and mortality related to metabolic syndrome.