Nickan Research Institute Immunopathologia Persa 2423-8015 11 2 2025 07 01 Association between metabolic syndrome and risk of endometrial cancer; a systematic review and meta-analysis e41724 e41724 10.34172/ipp.2025.41724 EN Sheida Abbasi https://orcid.org/0009-0008-7223-075X Jalal Rezaei https://orcid.org/0009-0000-9601-9803 Fariba Bazi https://orcid.org/0009-0003-9120-6601 Moloud Alsadat Mousavi https://orcid.org/0009-0006-8534-3206 Sadaf Rassouli https://orcid.org/0009-0002-8264-7766 Zeinab Zamanpour https://orcid.org/0000-0002-0994-365X Elmira Hosseini https://orcid.org/0000-0003-2817-606X Marziyeh Noori https://orcid.org/0000-0002-5472-291X Zahra Hamidi Madani https://orcid.org/0000-0002-7903-8364 Journal Article 10.34172/ipp.2025.41724 2024 07 29 2024 11 17 Introduction: Endometrial cancer is one of the most prevalent female malignancies, with various factors, including metabolic syndrome, contributing to its incidence. Thus, this study aims to evaluate the association between metabolic syndrome and the risk of endometrial carcinoma. Materials and Methods: In this systematic review and meta-analysis, two independent authors searched electronic databases, including Cochrane, PubMed, ProQuest, Web of Science, and the Google Scholar search engine up to May 16, 2024. Data analysis was conducted using STATA 14 software with a significance level of P < 0.05 for all tests. Results: A pooled analysis of 12 observational studies found that metabolic syndrome elevated the risk of endometrial carcinoma by 37% overall (OR: 1.37, 95% CI: 1.33, 1.42), 35% in cohort studies (OR: 1.35, 95% CI: 1.29, 1.42), and 40% in case-control studies (OR: 1.40, 95% CI: 1.33, 1.48). However, hypertension increased the risk of endometrial carcinoma by 25% (OR: 1.25, 95% CI: 1.18, 1.33), fasting hyperglycemia by 25% (OR: 1.25, 95% CI: 1.15, 1.37), hypertriglyceridemia by 17% (OR: 1.17, 95% CI: 1.13, 1.21), low high density lipoprotein (HDL) by 20% (OR:1.20, 95% CI: 1.12, 1.28), increased waist circumference by 59% (OR:1.59, 95% CI: 1.43, 1.77), pre-menopausal period by 67% (OR:1.67, 95% CI: 1.38, 2.02), and post-menopausal period by 61% (OR: 1.61, 95% CI: 1.17, 2.21). Likewise, obesity almost doubled the risk of endometrial carcinoma (OR: 2.13, 95% CI: 1.65, 2.75). Conclusion: Metabolic syndrome increases the risk of endometrial carcinoma, with obesity being the most dangerous risk factor for endometrial cancer. Thus, managing metabolic disorders in women can be an important step toward reducing the incidence of endometrial cancer. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024551509) and Research Registry (UIN: reviewregistry1838).