Prevalence of metabolic syndrome among primary and secondary school teachers: a systematic review and meta-analysis.

BACKGROUND: Schoolteachers are considered at increased risk for metabolic syndrome due to high psychosocial demands, sedentary occupational routines, and restricted opportunities for regular physical activity. However, the prevalence of metabolic syndrome among primary and secondary schoolteachers has not been systematically quantified. OBJECTIVE: To synthesize and quantify the available evidence on the prevalence of metabolic syndrome in primary and secondary school teachers worldwide through a systematic review and meta-analysis. METHODS: A systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 guidelines and the protocol was prospectively registered in PROSPERO (CRD420251034493). Searches were performed in the PubMed, Scopus, and Web of Science databases from their inception until April 27, 2026. Observational studies reporting the prevalence of MetS in primary and secondary school teachers were included. Methodological quality was assessed using the National Heart, Lung, and Blood Institute's tool for cohort and cross-sectional observational studies. Prevalence estimates were logit-transformed and pooled using a random-effects model with restricted maximum likelihood estimation. Heterogeneity was quantified using I2 and Cochran's Q. Subgroup and sensitivity analyses were performed by sex, methodological quality, diagnostic criteria, and geographic region. Publication bias was assessed using Egger's test and the trim-and-fill procedure. RESULTS: Fourteen cross-sectional studies involving 8,107 schoolteachers from 10 countries were included. The pooled prevalence of MetS was 30% (95% CI: 22-38%), with very high between-study heterogeneity (I 2 =98.34%). Central obesity, dyslipidemia, and hypertension were the most frequently reported components. The highest pooled prevalence was observed in studies conducted in Asia (35, 95% CI: 25-45%), whereas the single European study reported the lowest prevalence (9, 95% CI: 8-10%). CONCLUSION: Across the included studies, approximately three in 10 schoolteachers met the diagnostic criteria for MetS, although prevalence estimates varied widely across settings. These findings support the integration of cardiometabolic risk assessment into occupational health services for schoolteachers and the development of workplace health promotion strategies focused on physical activity, healthy eating, and routine monitoring of metabolic health. Educational institutions and public health authorities should consider context-specific preventive approaches, while future longitudinal studies using standardized diagnostic criteria and detailed occupational exposure assessments are needed to strengthen the evidence base. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251034493, CRD420251034493.