Frontiers in Public Health · Nov 2, 2026
Characterizing Metabolic Syndrome in Middle Eastern and North African Adults Residing in the United States: Insights from the All of Us Research Program to Advance Health Research Representation
By Eissa A. Jafari, Abdulkarim Alshammari, Ali Hanbashi
Background: Metabolic syndrome (MetS) is well studied in the United States (U.S.) population, but remains less characterized among Middle Eastern and North African (MENA) adults residing in the U.S., partially due to their historical misclassification within broader racial and ethnic categories. Therefore, this study aimed to characterize prevalence, components distribution, and factors associated with MetS among MENA adults residing in the U.S. using data from the All of Us Research Program. Methods: We conducted a cross-sectional study using Controlled Tier version 8 data from the All of Us Research Program. Participants were included in the study if they were aged ≥18 years, self-identified as MENA, had documented sex at birth, had at least one clinical encounter, and had data available on at least one of the MetS components. MetS was defined using criteria adapted from the National Cholesterol Education Program Adult Treatment Panel III, requiring presence of at least three of the five MetS components. Components distribution was examined in the overall MENA population, among MetS participants, and by birthplace, age, and sex subgroups. A multivariable stepwise logistic regression model was used to identify factors independently associated with MetS. Results: Among 2,733 participants included in the study, 639 (23%) met the criteria for MetS. In the overall MENA population, MetS components varied significantly by birthplace, age, and sex. Among participants with MetS, low HDL cholesterol (92%), elevated triglycerides (91%), and elevated blood pressure (86%) were the most prevalent components. Factors significantly associated with MetS included age ≥50 years (odds ratio [OR] 5.78), sleep apnea (OR 4.34), liver disease (OR 2.99), anxiety (OR 2.57), obesity (OR 2.36), vitamin D deficiency (OR 2.24), hypothyroidism (OR 2.06), male sex (OR 1.79), unemployment (OR 1.55), and family history of diabetes (OR 1.51). Conclusions: In the U.S.-based MENA cohort, nearly one-quarter of adults had MetS, with component patterns varying by birthplace, age, and sex. These findings support recognizing MENA adults as a distinct population in U.S. biomedical research and highlight the need for longitudinal and disaggregated studies to better understand cardiometabolic risk and inform targeted prevention strategies in this population.