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Effectiveness of interventions for reducing diabetes and cardiovascular disease risk in people with metabolic syndrome: Systematic review and mixed treatment comparison meta-analysis
Abstract
AIMS: To review the evidence on interventions for reversing metabolic syndrome or preventing development of type 2 diabetes and cardiovascular disease in people with metabolic syndrome. METHODS: A systematic review and Bayesian mixed treatment comparison meta-analysis was conducted. Relevant electronic bibliographic databases were searched up to January 2010. Included studies were randomized controlled trials with a follow-up of ≥24 weeks and outcomes comparing incidence of diabetes and/or cardiovascular disease, or reversal of metabolic syndrome. RESULTS: A total of 16 studies met the inclusion criteria. Thirteen studies with outcome data for reversal of metabolic syndrome, involving 3907 participants, were included in the meta-analysis. Insufficient trials reported cardiovascular events/mortality, or incidence of type 2 diabetes, to conduct a meta-analysis for these outcomes. Interventions, alone or in combination, included lifestyle (diet and/or exercise) and pharmacological therapy. Using random-effect models, both lifestyle (odds ratio, OR 3.81; 95% confidence interval, CI 2.47-5.88) and pharmacological interventions (OR 1.59; 95% CI 1.04-2.45) were statistically superior compared with control for reversing metabolic syndrome. Using mixed treatment comparison methods, the probability that lifestyle interventions were the most clinically effective was 87%. CONCLUSIONS: Evidence suggests that both lifestyle and pharmacological interventions can reverse metabolic syndrome. However, there is a lack of data on whether these benefits are sustained and translate into longer term prevention of diabetes and/or cardiovascular disease.
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“Results of a meta-analysis of 16 RCTs with ≥24 weeks of follow-up using lifestyle interventions including diet and exercise, showed a four-fold increased probability of metabolic syndrome remission compared to pharmaceutical interventions [203].”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [203]
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Metadata
- Authors
- Dunkley, A. J., Charles, K., Gray, L. J., Camosso‐Stefinovic, J., Davies, M. J., & Khunti, K.
- Affiliations
- University of Leicester (GB)
- Corresponding author
- Dunkley, A. J.
- Venue
- Diabetes Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2012-02-21
- Volume
- 14
- Issue
- 7
- Pages
- 616-625
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W2091832011
- Cited by
- 151
- References
- 46
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 6 · 2023: 3 · 2022: 8 · 2021: 11 · 2020: 15 · 2019: 13 · 2018: 9 · 2017: 14 · 2016: 9 · 2015: 16 · 2014: 17 · 2013: 13 · 2012: 2
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion)
- Funders
- National Institute for Health and Care Research (RP-DG-1210-10183, RP-PG-0606-1272)
- University of Leicester
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- metabolic syndrome, type 2 diabetes prevention, cardiovascular disease prevention, lifestyle intervention, pharmacotherapy, diet, physical activity, diabetes risk
- MeSH terms
- Bayes Theorem, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Prognosis, Exercise, Odds Ratio, Outcome Assessment, Health Care, Metabolic Syndrome, Risk Reduction Behavior
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