Global prevalence of insulin resistance in the adult population: a systematic review and meta-analysis

Objective: To determine the global prevalence of IR, evaluating differences according to study designs and population characteristics. Methodology: A systematic review with meta-analysis was conducted. The search encompassed MEDLINE (PubMed), Scopus, Web of Science, and EMBASE, including observational studies that employed the HOMA-IR index to estimate IR and published adult prevalence data. Articles without clear IR definitions or with highly specific populations were excluded. The meta-analysis applied a random-effects model with proportion transformation (Freeman-Tukey), assessing heterogeneity with I² and Cochran’s Q test. Additionally, a meta-regression by publication year was conducted. Results: Eighty-seven studies were included, with 235,148 participants. The pooled prevalence of IR was estimated at 26.53% (95% CI: 24.10–29.03; I²=99%), with no statistically significant differences when comparing probabilistic versus non-probabilistic sampling or when stratifying by sex. The meta-regression revealed no clear variations according to publication year or other explored factors. Conclusions: This systematic review demonstrates that IR reaches a global prevalence of 26.53%, with estimated differences between 26% and 30% across different populations and geographical regions. Despite the diversity in cut-off points employed for HOMA-IR, no statistically significant differences were observed when comparing sampling designs or stratifying by sex. Furthermore, no clear trend related to publication year was evidenced.