Metabolic Comorbidities in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

BackgroundChronic rhinosinusitis (CRS) may share inflammatory pathways with metabolic disorders, yet the extent of its associations with metabolic comorbidities and metabolic syndrome-related abnormalities remains uncertain. Given the rising prevalence of both CRS and metabolic disease, clarifying these relationships has important clinical and public health implications.ObjectiveTo systematically evaluate reported metabolic comorbidities and metabolic parameters in patients with CRS.MethodsA search of CINAHL, Cochrane Library, PubMed, and Scopus (inception-June 2025) identified studies reporting individual metabolic comorbidities and parameters in CRS. Meta-analyzed outcomes included means, proportions (%), and odds ratios (ORs) with 95% confidence intervals (CI).ResultsAltogether, 53 studies were included. Among 1 115 790 CRS patients, pooled prevalences were 45.1% for body mass index >25 kg/m², 25.3% for hypertension, 22.0% for dyslipidemia, and 11.7% for diabetes. Mean metabolic parameters trended slightly above population averages (eg, total cholesterol 195 mg/dL vs ∼189 mg/dL in global adults). CRS patients had comparable odds of diabetes (OR, 1.03; 95% CI, 0.87-1.22) and hypertension (OR, 1.04; 95% CI, 0.81-1.35), but lower odds of total cholesterol >240 mg/dL (OR, 0.96; 95% CI, 0.96-0.97), versus non-CRS controls.ConclusionMetabolic comorbidities were frequently reported among CRS populations, although pooled prevalence estimates were generally comparable to global reference estimates. Comparative analyses showed comparable odds of diabetes and hypertension between CRS patients and non-CRS controls, with lower odds of elevated total cholesterol among CRS patients. Overall, current evidence does not support a strong epidemiologic association between CRS and metabolic dysfunction, highlighting the need for prospective controlled studies to clarify potential relationships.