Characteristics of included primary studies.

IntroductionThis systematic review and meta-analysis aimed to estimate the prevalence of metabolic syndrome (MetS) among Iranian postmenopausal women by addressing inconsistencies in prior research and providing reliable data to inform evidence-based policies for reducing Iran’s MetS burden.MethodsMedline/PubMed, Scopus, Embase, Web of Science, Google Scholar, IMEMR, SID, MagIran, ISC, IranDoc/Ganj, Civilica, and RPIS were searched from their dates of inception until April 2025. The quality of the evidence was assessed using the Joanna Briggs Institute critical appraisal checklist. The prevalence of MetS was calculated using the random effects model using Stata version 17. Additionally, sensitivity analysis, subgroup analysis, meta-regression, and publication bias were assessed. The protocol is registered in PROSPERO, number CRD420251039469.ResultsA total of 24 papers were enrolled, comprising 17,281 postmenopausal participants with a pooled estimate of 58.42% (95%CI: 52.35–64.48, I2: 98.59%, Q: 836.97) MetS among Iranian postmenopausal females. The prevalence of MetS was 64.10%, 47.01%, 63.24%, and 50.16% in high-quality, medium-quality, population-based, and institutional-based studies, respectively. Moreover, meta-regression and subgroup analyses demonstrated study quality, study setting, and age as considerable sources of heterogeneity.ConclusionThis study highlights a high prevalence of MetS (≈58.5%) among Iranian postmenopausal women, with even greater estimates in high-quality and population-based studies, which underscores a significant public health concern. Given this substantial burden, routine screening for MetS components should be integrated into standard care for postmenopausal women, complemented by public health initiatives targeting lifestyle modifications and broader preventive strategies.