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Adults with Obstructive Sleep Apnoea (OSA) are considered to exhibit a higher risk of developing metabolic syndrome (MetS), with published data indicating that both conditions frequently co-exist. However, the strength and consistency of these data across epidemiological study designs remain unclear. The present analysis pools the odds ratio of MetS in adults with polysomnography-confirmed OSA compared to controls without OSA, based on case-control studies identified within the context of a broader systematic review.We conducted a systematic review of peer-reviewed primary research articles published in English until November 2024 from four databases (Ovid Medline, CINAHL, Embase, and Cochrane). A total of 81 primary studies, including case-control, cross-sectional, cohort study designs, and randomised clinical trials, were eligible for inclusion and data extraction. Herein, we meta-analysed the identified seven eligible case-control studies for this interim evidence synthesis. Meta-analysis was conducted using a random-effects model, and the summary effect estimate is reported. Publication bias was assessed using funnel plot and Egger’s test. The protocol is registered in PROSPERO 2025 CRD420251073055.The seven case-control studies comprised 477 OSA cases and 425 controls (predominantly males with age ranging between 45 and 50 years). Adults with OSA had almost 3.5-fold higher odds of having MetS compared to their counterparts without the disease (OR = 3.47; 95% CI: 1.63 - 7.39) (figure 1). Moderate heterogeneity was evident across these studies (I2 = 66.5%, Q (6) = 17.9, p < .01). No publication bias was detected.The present findings suggest that adults with OSA have a significantly higher risk of MetS. Despite the strength of these findings, interpretation should also be cautious due to the limited number of studies and their observational design. Additional analyses including all identified study designs are planned, and will be presented in a systematic review and three-level meta-analysis.Abstract S23 Figure 1