Table 1.
Characteristics of the included studies
| Author | Year | Country | Median/mean/Range age (IQR/SD) | Participants (male/female) | Comorbidities (n) | MetS definition criteria | Marker analyzed | Marker mean (SD) in patients with MetS | Marker mean (SD) in patients without MetS | Assay Method | Odds Ratio (95% CI) | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Obesity | CHD | HT | DM | |||||||||||
| Bonora E et al | 2003 | Italy | MetS: 60.7(11.6) Control: 58.5(11.4) | 888(446/442) | NR | NR | 551 | 201 | NCEP-ATP III | ApoA1 | 150 (30) | 170(30) | IN | NR |
| ApoB | 150 (40) | 120(30) | IN | NR | ||||||||||
| Muntner P et al | 2004 | United States of America | ≥ 20 | 7347(NR/NR) | NR | NR | NR | NR | NCEP-ATP III | ApoA1 | NR | NR | IN | 2.27 (1.30–3.96) |
| ApoB | NR | NR | IN | 2.97 (2.03–4.34) | ||||||||||
| Lp(a) | NR | NR | IN | 0.78 (0.54–1.12) | ||||||||||
| Panagiotakos D et al | 2004 | Greece | MetS: 55(13) Control: 45(13) | 2282(1126/1154) | 466 | NR | 897 | NR | NCEP-ATP III | ApoA1 | 146.45 (71.77) | 158.04(26.1) | IN | NR |
| ApoB | 123.95 (28.42) | 105.35(41.27) | IN | NR | ||||||||||
| Lp(a) | 17.65 (22.07) | 19.84(28.95) | IN | NR | ||||||||||
| Blatter M et al | 2005 | Switzerland | MetS: 62.1(8.1) Control: 59.6(9.6) | 773(558/215) | NR | 606 | NR | 145 | WHO 1999 | ApoA1 | 91 (17) | 97 (22) | IN | NR |
| ApoB | 98 (21) | 96 (23) | IN | NR | ||||||||||
| Guven A et al | 2005 | Turkey | MetS:38(25–48) Control:35(26–48) | 101(49/52) | NR | NR | NR | NR | NCEP-ATP III | Lp(a) | 51.1 (85.48) | 25.25 (42.07) | IN | NR |
| Lind L et al | 2005 | Sweden | 50–70 | 1826(1826/0) | NR | NR | NR | NR | NCEP-ATP III | ApoA1 | 126(19) | 146(25) | RIA | NR |
| ApoB | 137(28) | 122(27) | RIA | NR | ||||||||||
| ApoB/ApoA1 ratio | 1.11(0.27) | 0.86(0.24) | - | NR | ||||||||||
| Cankurtaran M et al | 2006 | Turkey | 71.8(6.3) | 1255(466/789) | 574 | 427 | 1117 | 732 | NCEP-ATP III | ApoA1 | NR | NR | IN | 0.997 (0.992–1.002) |
| ApoB | NR | NR | IN | 1.005 (1–1.01) | ||||||||||
| Lp(a) | NR | NR | IN | 1 (0.992–1.007) | ||||||||||
| Sierra-Johnson J et al | 2006 | United States of America | 46.8(19) | 2954 (1516/1448) | NR | NR | NR | NR | NCEP-ATP III | ApoB/ApoA1 ratio | 0.91 (0.2) | 0.69 (0.2) | – | NR |
| Al-Daghri N et al | 2007 | Saudi Arabia | MetS: 48.82(12.22) Control: 41.05(10.15) | 581(294/287) | NR | 154 | NR | 186 | IDF | ApoA1 | 106 (144) | 83 (26) | IT | NR |
| Pei W et al | 2007 | China | ≥ 20 | 560(268/292) | NR | NR | NR | NR | NCEP-ATP III | ApoA1 | NR | NR | IT | 0.951 (0.937–0.965) |
| ApoB | NR | NR | IT | 1.064 (1.048–1.080) | ||||||||||
| De Souza J et al | 2008 | France | MetS: 53(10) Control: 46(12) | 23(23/0) | NR | NR | NR | NR | NCEP-ATP III | ApoA1 | 136(23) | 159(16) | IN | NR |
| ApoB | 133(24) | 85(19) | IN | NR | ||||||||||
| Hye J et al. (A) | 2008 | South Korea | 20–78 | 1671(1671/0) | NR | NR | NR | NR | NCEP-ATP III | ApoB | 99.7 (22.6) | 86.5(23.5) | IT | NR |
| Hye J et al. (B) | 2008 | South Korea | 20–78 | 1664(0/1664) | NR | NR | NR | NR | NCEP-ATP III | ApoB | 100.1 (23.5) | 77.4(24.9) | IT | NR |
| Kotani K et al | 2008 | Japan |
MetS: 71(6.6) Control: 73.2(7.6) |
182(62/120) | NR | NR | NR | NR | NCEP-ATP III | Lp(a) | NR | NR | IT | 1.01 (0.99–1.03) |
| Onat A et al | 2008 | Turkey | 56.8(11.3) | 1309(608/701) | NR | NR | NR | NR | NCEP-ATP III | Lp(a) | NR | NR | IN | 0.62(0.47–0.81) |
| Pitsavos C et al | 2008 | Greece | MetS: 51(13) Control: 43(13) | 3042(1518/1524) | 438 | NR | 622 | NR | NCEP-ATP III | ApoA1 | NR | NR | IN | 0.94 (0.90–0.98) |
| ApoB | NR | NR | IN | 1.09(1–1.18) | ||||||||||
| ApoB/ApoA1 ratio | NR | NR | – | 2.3(1.65–3.2) | ||||||||||
| Dullaart R et al | 2009 | Netherlands | MetS: 59(10) Control: 55(9) | 79(43/36) | NR | NR | NR | NR | NCEP-ATP III | ApoA1 | 130 (24) | 147 (20) | IT | NR |
| ApoB | 99 (22) | 93 (25) | IT | NR | ||||||||||
| Boumaiza I et al | 2010 | Tunisia | MetS: 62.6(9.3) Control: 59.7(10.2) | 192(NR/NR) | NR | 113 | 91 | 72 | IDF | ApoA1 | 125 (4.2) | 154 (39) | IN | NR |
| ApoB | NR | NR | IN | 2.80 (1.50–5.21) | ||||||||||
| ApoB/ApoA1 ratio | 1.58 (0.61) | 0.97 (0.41) | – | NR | ||||||||||
| Mattsson N et al | 2010 | Finland | 24–39 | 2183(NR/NR) | NR | NR | NR | NR | IDF | ApoA1 | 138 (22) | 150 (25) | IT | NR |
| ApoB | 131 (26) | 101 (23) | IT | NR | ||||||||||
| ApoB/ApoA1 ratio | 0.97 (0.21) | 0.69(0.2) | – | NR | ||||||||||
| Park J et al | 2010 | South Korea | MetS: 54.64(10.84) Control: 53.99(11.28) | 658(327/331) | NR | NR | NR | NR | NCEP-ATP III | ApoB/ApoA1 ratio | 0.75 (0.25) | 0.69 (0.41) | – | NR |
| Riediger N et al | 2010 | Canada | ≥ 18 | 475(NR/NR) | NR | NR | 201 | 140 | NCEP-ATP III | ApoA1 | 113 (17) | 120 (18) | IN | NR |
| ApoB | 102 (26) | 80 (23) | IN | NR | ||||||||||
| ApoB/ApoA1 ratio | 0.9 (0.22) | 0.65 (0.2) | – | NR | ||||||||||
| Belfki H et al | 2011 | Tunisia | MetS: 54.9(11) Control: 50.4(13.2) | 330(94/236) | NR | NR | NR | NR | NCEP-ATP III | ApoA1 | 149 (28) | 167(31) | IT | NR |
| ApoB | 97 (23) | 80(19) | IT | NR | ||||||||||
| ApoB/ApoA1 ratio | 0.67 (0.19) | 0.49(0.13) | – | NR | ||||||||||
| Hee C et al. (A) | 2012 | South Korea | 51.8(10.9) | 7867(7867/0) | NR | 297 | 2438 | 902 | NCEP-ATP III | ApoB/ApoA1 ratio | NR | NR | – | 2.43(2.17–2.72) |
| Hee C et al. (B) | 2012 | South Korea | 51.9(9) | 3073(0/3073) | NR | 108 | 724 | 179 | NCEP-ATP III | ApoB/ApoA1 ratio | NR | NR | – | 3.84(3.13–4.71) |
| Won D et al | 2012 | South Korea | 52.9(8.2) | 244(159/85) | NR | NR | 100 | 76 | NCEP-ATP III | ApoA1 | 128 (20.3) | 137.4(18.5) | IT | NR |
| ApoB | 101.7 (24.2) | 88.9(20.4) | IT | NR | ||||||||||
| Li Y et al | 2013 | China | MetS: 27.36(4.79) Control: 26.68(4.18) | 185(0/185) | NR | NR | NR | NR | IDF | ApoA1 | 101 (20) | 125(30) | IT | NR |
| ApoB | 93 (16) | 72(17) | IT | NR | ||||||||||
| ApoB/ApoA1 ratio | 0.89 (0.21) | 0.6(0.18) | – | NR | ||||||||||
| Sung K et al | 2013 | South Korea | 42.42(6.91) | 14,283(12,031/2252) | NR | 102 | 1704 | 539 | HDM | Lp(a) | NR | NR | IT | 0.96(0.84–1.09) |
| Won S et al. (A) | 2013 | South Korea | MetS: 51.6(9.2) Control: 50.5(9.4) | 23,010(23,010/0) | NR | NR | NR | NR | HDM | ApoA1 | 132.2(24.1) | 139.2(23.4) | IT | NR |
| ApoB | 102.7(21.5) | 93(20.9) | IT | NR | ||||||||||
| ApoB/ApoA1 ratio | 0.8(0.21) | 0.69(0.2) | – | NR | ||||||||||
| Won S et al. (B) | 2013 | South Korea | MetS: 56.9(8.9) Control: 49.2(8.9) | 18,811(0/18811) | NR | NR | NR | NR | HDM | ApoA1 | 137.9(23.3) | 152.6(25) | IT | NR |
| ApoB | 103.8(22.3) | 85.8(21.3) | IT | NR | ||||||||||
| ApoB/ApoA1 ratio | 0.77(0.21) | 0.58(0.18) | – | NR | ||||||||||
| Jing F et al | 2014 | China | MetS: 55.7(12.68) Control: 49.27(15.14) | 8120(3781/4339) | NR | 179 | 2469 | 600 | IDF | ApoB/ApoA1 ratio | NR | NR | – | 4.3 (3.48–5.31) |
| Makaridze Z et al. (A) | 2014 | Georgia | 18–80 | 869(869/0) | NR | NR | NR | NR | NCEP-ATP III | ApoB/ApoA1 ratio | NR | NR | – | 1.18(0.58–2.4) |
| Makaridze Z et al. (B) | 2014 | Georgia | 18–80 | 653(0/653) | NR | NR | NR | NR | NCEP-ATP III | ApoB/ApoA1 ratio | NR | NR | – | 1.75(0.78—3.9) |
| Prasad M et al | 2014 | India | 43(10) | 1000(701/299) | NR | 24 | 307 | 163 | HDM | Lp(a) | NR | NR | IT | 0.7(0.5–1) |
| Savinova O et al | 2014 | United States of America | 44.96(12.3) | 70(42/28) | NR | NR | 14 | NR | NCEP-ATP III | ApoA1 | 98.86(19.1) | 117.76(14.9) | Electrophoresis | NR |
| ApoB | 87.96(23.2) | 69.86(17.4) | Electrophoresis | NR | ||||||||||
| Chou YL et al. (A) | 2015 | China | 39.8(15.61) | 1531(1531/0) | 192 | NR | 201 | 57 | HDM | ApoB/ApoA1 ratio | NR | NR | – | 2.86 (1.6–5.1) |
| Chou YL et al. (B) | 2015 | China | 39.8(15.61) | 1811(0/1811) | 155 | NR | 126 | 65 | HDM | ApoB/ApoA1 ratio | NR | NR | – | 2.01 (1.67–2.41) |
| Lim Y et al | 2015 | South Korea | MetS: 58.6(12.8) Control: 58.1(13.4) | 912(516/396) | NR | NR | NR | 912 | NCEP-ATP III | ApoB | 104.5 (53.3) | 87.7(33.7) | IN | NR |
| Barkas F et al | 2016 | Greece | MetS: 57(50–64) Control: 52(43–61) | 738(314/424) | NR | NR | NR | NR | HDM | ApoA1 | 141 (30) | 155(30) | IN | NR |
| ApoB | 122 (25) | 123(31) | IN | NR | ||||||||||
| Lp(a) | 10.65 (9.92) | 14.97(14.59) | IN | NR | ||||||||||
| Gentile M et al | 2016 | Italy | MetS: 64.1(7.4) Control: 62.5(8.7) | 222(0/222) | NR | NR | NR | NR | AHA/NLBI | ApoB | 110 (20) | 100 (20) | IT | NR |
| Lp(a) | 19.1 (22.1) | 27.9 (29.7) | ELISA | NR | ||||||||||
| Borja M et al | 2017 | United States of America | MetS: 47(10) Control: 45(12) | 74(44/30) | NR | NR | 13 | NR | HDM | ApoA1 | 98 (19) | 116 (14) | Electrophoresis | NR |
| Sreckovic B et al | 2017 | Serbia | 30–75 | 76(NR/NR) | NR | NR | NR | NR | NCEP-ATP III | ApoB | 108 (29) | 91 (25) | IT | NR |
| Vaverková H et al | 2017 | Czech Republic | 45.6(14) | 607(295/312) | NR | NR | NR | NR | HDM | Lp(a) | NR | NR | IT | 0.309 (0.184–0.516) |
| Andrea G et al | 2018 | India | MetS: 55.6(5.66) Control: 52.98(6.76) | 100(53/47) | NR | NR | NR | NR | AHA/NLBI | ApoA1 | 89.06 (24.1) | 173.13(24.11) | IN | NR |
| ApoB/ApoA1 ratio | 1.93 (1.18) | 0.48(0.13) | – | NR | ||||||||||
| Mokhsin A et al. (A) | 2018 | Malaysia | MetS: 49.53(11.7) Control: 40(14.69) | 1177(465/712) | NR | NR | 1246 | 98 | IDF | Lp(a) | 6 (4) | 6 (4) | IT | NR |
| Mokhsin A et al. (B) | 2018 | Malaysia | Mets: 30.56(11.1) Control: 31.29(11) | 150(79/71) | NR | NR | 86 | 3 | IDF | Lp(a) | 23 (26) | 22 (22) | IT | NR |
| Boiko A et al | 2019 | Russia | 35(25.5–42.5) | 53(27/26) | NR | NR | NR | NR | IDF | ApoA1 | 48.69 (16.07) | 56.3 (24.25) | IT | NR |
| Du R et al | 2019 | China | 58.5(9.7) | 10,340(3940/6400) | NR | NR | NR | NR | NCEP-ATP III | ApoB | NR | NR | CLIA | 1.49 (1.43–1.55) |
| Jun J et al | 2019 | South Korea | 51.6(NR) | 10,150(6141/4009) | NR | NR | NR | NR | NCEP-ATP III | Lp(a) | NR | NR | IT | 0.63(0.49–0.80) |
| Reynoso-Villalpando G et al | 2019 | Spain | MetS: 65(9.94) Control: 68(1.3) | 100(65/35) | 50 | NR | 80 | 100 | NCEP-ATP III | ApoA1 | 132.45 (15.91) | 145.96(17.5) | IT | NR |
| ApoB | 84.84 (20.2) | 75.65(19.03) | IT | NR | ||||||||||
| ApoB/ApoA1 ratio | 0.61 (0.16) | 0.5(0.16) | – | NR | ||||||||||
| Lp(a) | 28.99 (36) | 33.88(40.11) | IT | NR | ||||||||||
| Wu X et al | 2019 | China | ≥ 40 | 10,336(3944/6392) | NR | 1270 | 6259 | 1488 | NCEP-ATP III | Lp(a) | NR | NR | IT | 1.67(1.52–1.83) |
| Cardoso-Saldaña G et al | 2020 | Mexico | MetS: 54.1(8.8) Control: 52.7(9.6) | 953(481/472) | NR | NR | NR | NR | NCEP-ATP III | Lp(a) | 4.7 (5.11) | 6.85 (7.85) | IN | NR |
| Nurtazina A et al | 2020 | Kazakhstan | 25–75 | 704(314/390) | NR | 158 | 408 | NR | IDF | ApoB/ApoA1 ratio | NR | NR | – | 4.73 (3.01–7.43) |
| Rohit A et al | 2020 | India | 21–80 | 150(90/60) | NR | NR | NR | NR | AHA/NLBI | ApoA1 | 113.91 (24.22) | 146.94(12.82) | IN | NR |
| ApoB | 126.09 (37.02) | 85.65(18.85) | IN | NR | ||||||||||
| Lp(a) | 19.33 (7.64) | 19.58(4.75) | IN | NR | ||||||||||
| He H et al | 2021 | China | 27.25(3) | 957(0/957) | NR | NR | NR | NR | IDF | ApoB/ApoA1 ratio | NR | NR | – | 8.7 (6.1–12.4) |
| Sharan H et al | 2022 | Nepal | MetS: 54.89(8.93) Control: 54.63(9.44) | 213(NR/NR) | NR | NR | NR | NR | NCEP-ATP III | ApoA1 | 101.36 (11.75) | 116.52(12.22) | IT | NR |
| ApoB | 115.22 (25.03) | 81.77(16.13) | IT | NR | ||||||||||
| ApoB/ApoA1 ratio | 1.14 (0.27) | 0.7 (0.15) | – | NR | ||||||||||
| Wang W et al | 2022 | China | 53.4(7.5) | 605(304/301) | NR | NR | 215 | 605 | CDS | ApoA1 | 96 (19) | 114 (20) | IT | NR |
AHA/NHLBI American Heart Association/National Heart, Lung, and Blood Institute, ApoB Apolipoprotein B, ApoA1 Apolipoprotein A1, CDS Chinese Diabetes Society, HDM Harmonized Definition of MetS, MetS Metabolic Syndrome, NCEP-ATP III National Cholesterol Education ProgramAdult Treatment Panel III, Lp(a) Lipoprotein(a), CLIA Chemiluminescence immunoassay, IT Immunoturbidimetric, IN Immunonephelometry, ELISA Enzyme-linked immune-sorbent assay, IDF International Diabetes Federation, NR Not Reported, RIA Radioimmunoassay, WHO World Health Organization