Global prevalence of metabolic syndrome among individuals with sarcopenia: a systematic review and meta-analysis of 72,129 patients

Sarcopenia is an age-related geriatric syndrome associated with an increased risk of metabolic syndrome (MS). However, the prevalence of MS among individuals with sarcopenia remains uncertain. This meta-analysis aimed to estimate the global pooled prevalence of MS in patients with sarcopenia. We conducted the first global systematic review to quantify the prevalence of MS among people with sarcopenia. A systematic search of PubMed, Web of Science, Scopus, Embase, and CINAHL Complete databases was conducted on 28 May 2025. Pooled prevalence was calculated with a random effects model. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity. This meta-analysis was prospectively registered in the PROSPERO database (Number: CRD420251115631). 15 studies involving 72,129 individuals with sarcopenia were ultimately included and sample sizes ranged from 47 to 61,438. The pooled prevalence of MS among individuals with sarcopenia was 30%(95% CI 22%–40%); with substantial between-study heterogeneity (I² = 99.3%, p < 0.001). Diagnostic criteria markedly influenced the estimates: studies using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definition yielded 29% (95% CI 22%–37%), whereas those employing the International Diabetes Federation (IDF) definition reported 47% (95% CI 46%–48%). Substantial geographic variation was observed, with relatively higher prevalence estimates reported in South Korea (39%, 95% CI 20%–59%). This study highlights the global prevalence of MS in individuals with sarcopenia, with comparatively higher pooled prevalence estimates observed in South Korea, the United States, and Australia. Standardized diagnostic criteria and unified management strategies for this comorbidity warrant urgent investigation.