The association between glycemic index, glycemic load, and metabolic syndrome: a systematic review and dose–response meta-analysis of observational studies

  • Jia-Yu Zhang
  • Yu-Ting Jiang
  • Ya-Shu Liu
  • Qing Chang
  • Yu-Hong Zhao
  • Qi-Jun WuEmail author



The association of glycemic index (GI) and glycemic load (GL) with metabolic syndrome (MetS) is controversial. Therefore, we conducted this first systematic review and dose–response meta-analysis of observational studies to quantify these associations.


We searched PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies up to 1 April 2019. Summary odds ratios (OR) and 95% confidence intervals (CI) were calculated by a random-effects model. This study was registered with PROSPERO (CRD42019131788).


We included eight high-quality (n = 5) or medium-quality (n = 3) cross-sectional studies in the final meta-analysis, comprising 6058 MetS events and 28,998 participants. The summary ORs of MetS for the highest versus lowest categories were 1.23 (95% CI 1.10–1.38, I2 = 0, tau2 = 0, n = 5) for dietary GI, 1.06 (95% CI 0.89–1.25, I2 = 36.2%, tau2 = 0.0151, n = 6) for dietary GL. The summary OR was 1.12 (95% CI 1.00–1.26, I2 = 0, tau2 = 0, n = 3) per 5 GI units, 0.96 (95% CI 0.83–1.10, I2 = 33.4%, tau2 = 0.0059, n = 2) per 20 GL units.


Dietary GI was positively associated with the prevalence of MetS. However, no significant association was found between dietary GL and the prevalence of MetS. Further studies with prospective design are needed to establish potential causal relationship between dietary GI and the MetS.


Glycemic index Glycemic load Metabolic syndrome Meta-analysis 


Author contributions

Q-JW and Y-HZ designed the study and formulated the clinical question. J-YZ and Y-TJ performed the literature search and reviewed the search results for study inclusion. J-YZ and Y-SL designed the data extraction form and extracted the data. All authors collected, managed, and analyzed the data. J-YZ drafted the manuscript. All authors prepared, reviewed, revised, and approved the manuscript. Q-JW had full access to all data in the study and is responsible for data integrity and the accuracy of data analysis. All authors read and approved the final manuscript.


This study was funded by National Key R&D Program of China (no. 2017YFC0907400).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

394_2019_2124_MOESM1_ESM.docx (832 kb)
Supplementary material 1 (DOCX 832 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Jia-Yu Zhang
    • 1
    • 2
  • Yu-Ting Jiang
    • 1
    • 2
  • Ya-Shu Liu
    • 1
    • 2
  • Qing Chang
    • 1
    • 2
  • Yu-Hong Zhao
    • 1
    • 2
  • Qi-Jun Wu
    • 1
    • 2
    Email author
  1. 1.Department of Clinical EpidemiologyShengjing Hospital of China Medical UniversityShenyangPeople’s Republic of China
  2. 2.Clinical Research CenterShengjing Hospital of China Medical UniversityShenyangChina

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