Olfactory Dysfunction and Metabolic Syndrome Components: A Systematic Review and Meta-Analysis

To elucidate the association between olfactory dysfunction (OD) and metabolic syndrome components.

PubMed (National Library of Medicine-National Institutes of Health), Scopus (Elsevier), CINAHL Complete (EBSCOhost), and the Cochrane Library (Wiley) databases were searched from inception through March 23rd, 2026.

Eligible studies were stratified by olfactory dysfunction or different metabolic parameters. Extracted variables included metabolic measures (BMI, waist circumference, cholesterol levels, blood pressure, fasting glucose, HbA1c), olfactory scores, and comorbidities. Data were summarized as means, proportions (%), and corresponding differences (Δ) with 95% confidence intervals (CI). Risk of bias was evaluated using the Joanna Briggs Institute (JBI) tool.

A total of 4045 studies were screened using Covidence, with 47 studies included for data analysis. Participants with OD demonstrated greater odds of smoking (OR = 1.2, p = 0.002), antihypertensive medication use (OR = 1.2, p = 0.03), atrial fibrillation (OR = 1.7, p < 0.00001), heart failure (OR = 1.6, p = 0.008), and diabetes (OR = 1.2, p < 0.0001). Additionally, adults with OD had higher fasting glucose (MD +0.8 mg/dL; p < 0.00001), lower total cholesterol (MD -6.0 mg/dL; p = 0.04), and lower HDL levels (MD -1.8 mg/dL; p < 0.00001). Individuals with diabetes and elevated BMI had significantly lower TDI composite scores (MD -5.6; p < 0.00001 and MD -2.8; p < 0.00001, respectively).

Patients with OD showed increased rates of conditions that comprise and contribute to metabolic syndrome. Conversely, individuals with metabolic disorders exhibited lower mean scores on olfactory testing, indicating a bidirectional relationship between olfactory impairment and metabolic dysregulation.