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Despite growing evidence globally, there is a lack of research in the Gulf region, particularly in Oman. This study is the first to assess the prevalence and associated factors of MetS among Omani adults with mental illnesses. A descriptive cross-sectional design was employed. Three diagnostic criteria were used to assess MetS: the International Diabetes Federation (IDF) criteria, the modified Adult Treatment Panel III (ATP III), and the Joint Statement of the IDF Task Force with other organizations, aiming to enhance comparability and diagnostic consistency. A convenience sample of 251 Omani adults with mental illnesses was recruited from the outpatient departments of two tertiary hospitals in Muscat, Sultanate of Oman. Metabolic syndrome prevalence was 29.9%, 30.3%, and 33.1% according to the ATP III-A, IDF, and Joint Statement criteria, respectively. Logistic regression analysis showed that greater waist circumference (OR\u2009=\u20091.06, 95% CI: 1.03\u20131.09,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and higher triglyceride levels (OR\u2009=\u20092.43, 95% CI: 1.40\u20134.22,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002) were significantly associated with increased odds of MetS. Higher physical activity (OR\u2009=\u20090.97, 95% CI: 0.95\u20130.99,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.031) and the use of antidiabetic medication (OR\u2009=\u20090.17, 95% CI: 0.04\u20130.73,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.017) were associated with lower odds. Our findings indicate substantial metabolic risk among Omani adults with mental illnesses. Accordingly, two concrete service actions are warranted: embed routine metabolic screening within psychiatric outpatient care; and implement structured lifestyle-support programs prioritizing physical-activity counselling and weight-management\/nutrition referral pathways. These steps align directly with the study\u2019s observed risk profile.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-25948-8","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:57:57Z","timestamp":1764086277000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and associated factors of metabolic syndrome among Omani adults with mental illnesses: a cross-sectional study"],"prefix":"10.1038","volume":"15","author":[{"given":"Faisal","family":"Al Rashdi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Al Omari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blessy Prabha","family":"Valsaraj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasser","family":"Al-Sibani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aziza","family":"Al Sawafi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iman","family":"Al Hashmi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maen","family":"Aljezawi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Al Qadire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"ALBashtawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadwa","family":"Alhalaiqa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasser","family":"AL Salmi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"25948_CR1","doi-asserted-by":"publisher","unstructured":"American Psychiatric Association. 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