Metabolic Syndrome

    Researchedby:
    Mike Murray

    Fact-checked

    by:

    Morgan Pfiffner, Shyam Jayaraman
    Last Updated: October 13, 2024

    Metabolic syndrome refers to a group of cardiometabolic risk factors: abdominal obesity, high blood pressure, high fasting blood sugar, high blood triglycerides, and low HDL-C. If a person has at least three of these, they have metabolic syndrome.

    examine-databaseExamine Database

    Metabolic Syndrome falls under the Diabetes & Blood Sugar category.

    37 references on this page
    251,790 participants in 45 trials and 53 meta-analyses

    What is metabolic syndrome?

    Metabolic syndrome (MetS), sometimes called “insulin resistance syndrome” or “syndrome X”, refers to a cluster of interrelated risk factors for cardiovascular disease and type 2 diabetes, specifically enlarged waist circumference, elevated triglycerides, high blood pressure, low high-density lipoprotein cholesterol, and impaired fasting glucose.[1] It’s estimated that the global prevalence of MetS is about 25%,[2] while in the United States it’s nearly 35%.[3]

    Does metabolic syndrome increase the risk of developing other health conditions?

    What are the main signs and symptoms of metabolic syndrome?

    Other than an enlarged waist circumference, which doesn’t always indicate the presence of MetS, there are typically no obvious signs or symptoms of the disease. Therefore, an evaluation by a medical doctor and blood work will be needed to determine the presence of MetS. In some cases, an individual will present with signs of specific risk factors, such as acanthosis nigricans (a darkening of the skin that appears in skin fold areas and is associated with insulin resistance) or xanthomas (yellowish-colored skin lesions that are associated with dyslipidemia).[1]

    How is metabolic syndrome diagnosed?

    To be diagnosed with MetS, an individual needs to have at least 3 of the following 5 risk factors:[4]

    • Enlarged waist circumference: ≥ 88 centimeters (35 inches) and ≥ 102 centimeters (40 inches) in women and men, respectively, with lower thresholds for Asian populations (≥ 80 centimeters and ≥ 85–90 centimeters in women and men, respectively)
    • Elevated triglycerides: ≥ 150 mg/dL (1.7 mmol/L)
    • High blood pressure: systolic ≥ 130 mm Hg and/or diastolic ≥ 85 mm Hg
    • Low high-density lipoprotein cholesterol: < 50 mg/dL (1.3 mmol/L) and < 40 mg/dL (1.0 mmol/L) in women and men, respectively
    • Impaired fasting glucose (or drug treatment of elevated glucose levels): ≥ 100 mg/dL (5.6 mmol/L)

    What are some of the main medical treatments for metabolic syndrome?

    The primary goal of clinical management is to reduce the risk of cardiovascular disease and type 2 diabetes.[5] Lifestyle interventions (i.e., changes in dietary and physical activity habits and smoking cessation) are the initial strategy to treat MetS, followed by pharmacological therapy — if necessary — to improve individual risk factors. There are no guidelines from medical organizations for the pharmacological treatment of MetS; pharmacological treatment depends on the individual’s unique circumstances and may include a statin to improve blood lipids, a glucagon-like peptide 1 receptor agonist (GLP-1 RA) or sodium-glucose cotransporter 2 (SGLT2) inhibitor to further reduce cardiovascular disease risk, metformin to increase insulin sensitivity, and/or a renin-angiotensin system (RAS) blocker to reduce blood pressure, among other drugs.[6][7][8] In people with severe obesity, bariatric surgery is a highly effective option.

    How could diet affect metabolic syndrome?

    Maintaining a healthy body weight is central to the prevention and management of MetS. Virtually any calorie-restricted diet — irrespective of its macronutrient distribution or meal frequency — that the individual can adhere to has the potential to improve MetS risk factors.[9] To achieve significant improvement of MetS risk factors, a weight loss of at least 5% of initial body weight is recommended, with greater improvements reported with further weight loss.[10]

    Regarding specific dietary patterns, the Mediterranean diet, which is rich in minimally processed plant foods and olive oil, has the most robust evidence of improving MetS risk factors and reducing the prevalence of MetS.[11][12] The Dietary Approaches to Stop Hypertension (DASH) diet has also been shown to improve MetS risk factors, whereas a Western diet rich in red meat, saturated fatty acids, refined grains, and sugar is associated with an increased risk of MetS.[13]

    Have any supplements been studied for metabolic syndrome?

    Because MetS is characterized by a cluster of cardiometabolic risk factors, a wide variety of supplements are of interest, including those purported to improve blood lipids, increase insulin sensitivity, decrease blood pressure, or reduce inflammation. Some of the most studied options are berberine, red yeast rice, fish oil, biotic supplements, curcumin, vitamin D, and garlic.[14][15]

    Are there any other treatments for metabolic syndrome?

    Regular exercise is important for the prevention and treatment of MetS. Sedentary behavior is associated with an increased risk of MetS,[16][17] whereas higher cardiorespiratory fitness (i.e., VO2max) is associated with a reduced risk of MetS.[18] Additionally, regular exercise has been shown to improve each MetS risk factor.[18] At a minimum, the physical activity guidelines of 150 minutes per week of moderate-intensity (or 75 minutes of vigorous-intensity) activity should be met.

    Sleep hygiene interventions are also potentially useful because sleep deprivation increases hunger and energy intake and decrease insulin sensitivity.[19] Moreover, short sleep duration (<6 hours per night) and sleep apnea are associated with an increased risk of MetS.[20][21] Lastly, smoking cessation is recommended for the prevention and treatment of MetS.[13]

    What causes metabolic syndrome?

    MetS is caused by a combination of genetic[22][23] and environmental factors, namely a high caloric intake and physical inactivity.[24] The resultant excess adiposity — particularly in the intra-abdominal region (i.e., visceral fat) — leads to adipose tissue dysfunction and insulin resistance.

    Expansion of visceral fat and insulin resistance increases circulating free fatty acids (FFAs), which infiltrate the liver and skeletal muscle and disrupt glucose and lipid homeostasis.[24] The liver and skeletal muscle respond by increasing the breakdown of FFAs, which results in decreased glucose uptake in muscle along with increased glucose and triglyceride production and increased high-density lipoprotein clearance in the liver.[25][15]

    Additionally, expansion of visceral fat causes altered secretion of adipokines (i.e., hormones, cytokines, and other proteins secreted by fat tissue), including increased secretion of pro-inflammatory cytokines (e.g., interleukin-6, tumor necrosis factor alpha) and reduced secretion of adiponectin, contributing to a state of chronic low-grade inflammation and a deterioration in cardiometabolic health.[26]

    Which factors increase the risk of visceral adiposity?

    Examine Database: Metabolic Syndrome

    Resveratrol
    Chromium
    Curcumin
    Ketogenic Diet
    Mediterranean Diet
    Saffron
    L-Carnitine
    Whey Protein
    Black seed
    Inositol
    Berberine
    Betaine
    Cocoa Extract
    Dill
    Flaxseed
    Kefir
    Spirulina
    Vegan Diet
    Zinc
    16:8 Intermittent Fasting
    Alpha-Lipoic Acid
    Blueberry
    Casein
    Chlorella
    Coenzyme Q10
    Conjugated Linoleic Acid
    Fish Oil
    Folic Acid (Vitamin B9)
    Garlic
    Grape Seed Extract
    Grapefruit
    Green Tea Extract
    Hesperidin
    Honey
    Low-Fat Diet
    Magnesium
    Milk Protein
    Niacin (Vitamin B3)
    Olive Leaf Extract
    Paleolithic Diet
    Panax Ginseng (Korean Ginseng)
    Resistant Starch
    Roselle
    Soy Protein
    Vitamin D

    Research FeedRead all studies

    Frequently asked questions

    What is metabolic syndrome?

    Metabolic syndrome (MetS), sometimes called “insulin resistance syndrome” or “syndrome X”, refers to a cluster of interrelated risk factors for cardiovascular disease and type 2 diabetes, specifically enlarged waist circumference, elevated triglycerides, high blood pressure, low high-density lipoprotein cholesterol, and impaired fasting glucose.[1] It’s estimated that the global prevalence of MetS is about 25%,[2] while in the United States it’s nearly 35%.[3]

    Does metabolic syndrome increase the risk of developing other health conditions?

    Yes, MetS increases the risk of a number of conditions, including cardiovascular disease and type 2 diabetes, as well as all-cause mortality. Having MetS has been associated with the following increased health risks:

    • A 253%–417% higher risk of type 2 diabetes[28]
    • A 65%–118% higher risk of incident cardiovascular disease or events[29][30][31]
    • A 74%–117% higher risk of cardiovascular-disease-related mortality[30][31]
    • A 41%–60% higher risk of all-cause mortality[30][31]
    • 150% higher odds of polycystic ovary syndrome[32][33]
    • A higher risk of several cancers, including a 36% higher risk of colorectal cancer,[34], a 47% higher risk of breast cancer,[35] a 76% higher risk of liver cancer,[36] and an 89% higher risk of endometrial cancer[37]
    What are the main signs and symptoms of metabolic syndrome?

    Other than an enlarged waist circumference, which doesn’t always indicate the presence of MetS, there are typically no obvious signs or symptoms of the disease. Therefore, an evaluation by a medical doctor and blood work will be needed to determine the presence of MetS. In some cases, an individual will present with signs of specific risk factors, such as acanthosis nigricans (a darkening of the skin that appears in skin fold areas and is associated with insulin resistance) or xanthomas (yellowish-colored skin lesions that are associated with dyslipidemia).[1]

    How is metabolic syndrome diagnosed?

    To be diagnosed with MetS, an individual needs to have at least 3 of the following 5 risk factors:[4]

    • Enlarged waist circumference: ≥ 88 centimeters (35 inches) and ≥ 102 centimeters (40 inches) in women and men, respectively, with lower thresholds for Asian populations (≥ 80 centimeters and ≥ 85–90 centimeters in women and men, respectively)
    • Elevated triglycerides: ≥ 150 mg/dL (1.7 mmol/L)
    • High blood pressure: systolic ≥ 130 mm Hg and/or diastolic ≥ 85 mm Hg
    • Low high-density lipoprotein cholesterol: < 50 mg/dL (1.3 mmol/L) and < 40 mg/dL (1.0 mmol/L) in women and men, respectively
    • Impaired fasting glucose (or drug treatment of elevated glucose levels): ≥ 100 mg/dL (5.6 mmol/L)
    What are some of the main medical treatments for metabolic syndrome?

    The primary goal of clinical management is to reduce the risk of cardiovascular disease and type 2 diabetes.[5] Lifestyle interventions (i.e., changes in dietary and physical activity habits and smoking cessation) are the initial strategy to treat MetS, followed by pharmacological therapy — if necessary — to improve individual risk factors. There are no guidelines from medical organizations for the pharmacological treatment of MetS; pharmacological treatment depends on the individual’s unique circumstances and may include a statin to improve blood lipids, a glucagon-like peptide 1 receptor agonist (GLP-1 RA) or sodium-glucose cotransporter 2 (SGLT2) inhibitor to further reduce cardiovascular disease risk, metformin to increase insulin sensitivity, and/or a renin-angiotensin system (RAS) blocker to reduce blood pressure, among other drugs.[6][7][8] In people with severe obesity, bariatric surgery is a highly effective option.

    How could diet affect metabolic syndrome?

    Maintaining a healthy body weight is central to the prevention and management of MetS. Virtually any calorie-restricted diet — irrespective of its macronutrient distribution or meal frequency — that the individual can adhere to has the potential to improve MetS risk factors.[9] To achieve significant improvement of MetS risk factors, a weight loss of at least 5% of initial body weight is recommended, with greater improvements reported with further weight loss.[10]

    Regarding specific dietary patterns, the Mediterranean diet, which is rich in minimally processed plant foods and olive oil, has the most robust evidence of improving MetS risk factors and reducing the prevalence of MetS.[11][12] The Dietary Approaches to Stop Hypertension (DASH) diet has also been shown to improve MetS risk factors, whereas a Western diet rich in red meat, saturated fatty acids, refined grains, and sugar is associated with an increased risk of MetS.[13]

    Have any supplements been studied for metabolic syndrome?

    Because MetS is characterized by a cluster of cardiometabolic risk factors, a wide variety of supplements are of interest, including those purported to improve blood lipids, increase insulin sensitivity, decrease blood pressure, or reduce inflammation. Some of the most studied options are berberine, red yeast rice, fish oil, biotic supplements, curcumin, vitamin D, and garlic.[14][15]

    Are there any other treatments for metabolic syndrome?

    Regular exercise is important for the prevention and treatment of MetS. Sedentary behavior is associated with an increased risk of MetS,[16][17] whereas higher cardiorespiratory fitness (i.e., VO2max) is associated with a reduced risk of MetS.[18] Additionally, regular exercise has been shown to improve each MetS risk factor.[18] At a minimum, the physical activity guidelines of 150 minutes per week of moderate-intensity (or 75 minutes of vigorous-intensity) activity should be met.

    Sleep hygiene interventions are also potentially useful because sleep deprivation increases hunger and energy intake and decrease insulin sensitivity.[19] Moreover, short sleep duration (<6 hours per night) and sleep apnea are associated with an increased risk of MetS.[20][21] Lastly, smoking cessation is recommended for the prevention and treatment of MetS.[13]

    What causes metabolic syndrome?

    MetS is caused by a combination of genetic[22][23] and environmental factors, namely a high caloric intake and physical inactivity.[24] The resultant excess adiposity — particularly in the intra-abdominal region (i.e., visceral fat) — leads to adipose tissue dysfunction and insulin resistance.

    Expansion of visceral fat and insulin resistance increases circulating free fatty acids (FFAs), which infiltrate the liver and skeletal muscle and disrupt glucose and lipid homeostasis.[24] The liver and skeletal muscle respond by increasing the breakdown of FFAs, which results in decreased glucose uptake in muscle along with increased glucose and triglyceride production and increased high-density lipoprotein clearance in the liver.[25][15]

    Additionally, expansion of visceral fat causes altered secretion of adipokines (i.e., hormones, cytokines, and other proteins secreted by fat tissue), including increased secretion of pro-inflammatory cytokines (e.g., interleukin-6, tumor necrosis factor alpha) and reduced secretion of adiponectin, contributing to a state of chronic low-grade inflammation and a deterioration in cardiometabolic health.[26]

    Which factors increase the risk of visceral adiposity?

    As the accumulation of visceral fat is central to the development of MetS, it’s critical to know which factors increase the risk of this unfavorable storage of excess calories. The following factors are associated with an increased risk of developing MetS in people consuming excess calories:[26]

    • Age: the prevalence of MetS increases with aging because there is a change in fat tissue distribution that favors the storage of excess calories in visceral fat stores, as opposed to subcutaneous fat stores.
    • Sex: Visceral fat deposition is lower in women, specifically premenopausal women, than men.
    • Genetics: Visceral fat distribution has high heritability rates, as evidenced by family and twin studies. Genetic variants have also been identified that increase susceptibility to metabolic abnormalities from visceral fat accumulation.
    • Ethnicity: White populations display greater susceptibility to accumulate visceral fat than Black populations, and Asian populations demonstrate the greatest susceptibility to accumulate visceral fat.
    • Diet: A high consumption of sugar-sweetened beverages biases excess calories toward visceral fat, and a saturated fat-rich diet increases visceral fat compared to a polyunsaturated fat-rich diet.[27]

    References

    1. ^Supreeya Swarup, Amandeep Goyal, Yulia Grigorova, Roman ZeltserMetabolic Syndrome
    2. ^Saklayen MGThe Global Epidemic of the Metabolic SyndromeCurr Hypertens Rep.(2018 Feb 26)
    3. ^Hirode G, Wong RJTrends in the Prevalence of Metabolic Syndrome in the United States, 2011-2016.JAMA.(2020-06-23)
    4. ^Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr, International Diabetes Federation Task Force on Epidemiology and Prevention, Hational Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, International Association for the Study of ObesityHarmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of ObesityCirculation.(2009 Oct 20)
    5. ^Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F, American Heart Association, National Heart, Lung, and Blood InstituteDiagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific StatementCirculation.(2005 Oct 25)
    6. ^Lim S, Eckel RHPharmacological treatment and therapeutic perspectives of metabolic syndrome.Rev Endocr Metab Disord.(2014-Dec)
    7. ^, Draznin B, Aroda VR, Bakris G, Benson G, Brown FM, Freeman R, Green J, Huang E, Isaacs D, Kahan S, Leon J, Lyons SK, Peters AL, Prahalad P, Reusch JEB, Young-Hyman D9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2022.Diabetes Care.(2022-01-01)
    8. ^François Mach, Colin Baigent, Alberico L Catapano, Konstantinos C Koskinas, Manuela Casula, Lina Badimon, M John Chapman, Guy G De Backer, Victoria Delgado, Brian A Ference, Ian M Graham, Alison Halliday, Ulf Landmesser, Borislava Mihaylova, Terje R Pedersen, Gabriele Riccardi, Dimitrios J Richter, Marc S Sabatine, Marja-Riitta Taskinen, Lale Tokgozoglu, Olov Wiklund, ESC Scientific Document Group2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular riskEur Heart J.(2020 Jan 1)
    9. ^Bassi N, Karagodin I, Wang S, Vassallo P, Priyanath A, Massaro E, Stone NJLifestyle modification for metabolic syndrome: a systematic reviewAm J Med.(2014 Dec)
    10. ^Kenneth Cusi, Scott Isaacs, Diana Barb, Rita Basu, Sonia Caprio, W Timothy Garvey, Sangeeta Kashyap, Jeffrey I Mechanick, Marialena Mouzaki, Karl Nadolsky, Mary E Rinella, Miriam B Vos, Zobair YounossiAmerican Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD)Endocr Pract.(2022 May)
    11. ^Papadaki A, Nolen-Doerr E, Mantzoros CSThe Effect of the Mediterranean Diet on Metabolic Health: A Systematic Review and Meta-Analysis of Controlled Trials in Adults.Nutrients.(2020-Oct-30)
    12. ^Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DBThe effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals.J Am Coll Cardiol.(2011-Mar-15)
    13. ^Pérez-Martínez P, Mikhailidis DP, Athyros VG, Bullo M, Couture P, Covas MI, de Koning L, Delgado-Lista J, Díaz-López A, Drevon CA, Estruch R, Esposito K, Fitó M, Garaulet M, Giugliano D, García-Ríos A, Katsiki N, Kolovou G, Lamarche B, Maiorino MI, Mena-Sánchez G, Muñoz-Garach A, Nikolic D, Ordovás JM, Pérez-Jiménez F, Rizzo M, Salas-Salvadó J, Schröder H, Tinahones FJ, de la Torre R, van Ommen B, Wopereis S, Ros E, López-Miranda JLifestyle recommendations for the prevention and management of metabolic syndrome: an international panel recommendationNutr Rev.(2017 May 1)
    14. ^Sirtori CR, Pavanello C, Calabresi L, Ruscica MNutraceutical approaches to metabolic syndrome.Ann Med.(2017-Dec)
    15. ^Fahed G, Aoun L, Bou Zerdan M, Allam S, Bou Zerdan M, Bouferraa Y, Assi HIMetabolic Syndrome: Updates on Pathophysiology and Management in 2021.Int J Mol Sci.(2022-Jan-12)
    16. ^Thorp AA, Healy GN, Owen N, Salmon J, Ball K, Shaw JE, Zimmet PZ, Dunstan DWDeleterious associations of sitting time and television viewing time with cardiometabolic risk biomarkers: Australian Diabetes, Obesity and Lifestyle (AusDiab) study 2004-2005.Diabetes Care.(2010-Feb)
    17. ^Zhang D, Liu X, Liu Y, Sun X, Wang B, Ren Y, Zhao Y, Zhou J, Han C, Yin L, Zhao J, Shi Y, Zhang M, Hu DLeisure-time physical activity and incident metabolic syndrome: a systematic review and dose-response meta-analysis of cohort studies.Metabolism.(2017-10)
    18. ^Myers J, Kokkinos P, Nyelin EPhysical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome.Nutrients.(2019-Jul-19)
    19. ^Bingqian Zhu, Changgui Shi, Chang G Park, Xiangxiang Zhao, Sirimon ReutrakulEffects of sleep restriction on metabolism-related parameters in healthy adults: A comprehensive review and meta-analysis of randomized controlled trialsSleep Med Rev.(2019 Jun)
    20. ^Bo Xi, Dan He, Min Zhang, Jian Xue, Donghao ZhouShort sleep duration predicts risk of metabolic syndrome: a systematic review and meta-analysisSleep Med Rev.(2014 Aug)
    21. ^Qian Y, Xu H, Wang Y, Yi H, Guan J, Yin SObstructive sleep apnea predicts risk of metabolic syndrome independently of obesity: a meta-analysis.Arch Med Sci.(2016-Oct-01)
    22. ^Nagrani R, Foraita R, Gianfagna F, Iacoviello L, Marild S, Michels N, Molnár D, Moreno L, Russo P, Veidebaum T, Ahrens W, Marron MCommon genetic variation in obesity, lipid transfer genes and risk of Metabolic Syndrome: Results from IDEFICS/I.Family study and meta-analysis.Sci Rep.(2020-04-28)
    23. ^Kristiansson K, Perola M, Tikkanen E, Kettunen J, Surakka I, Havulinna AS, Stancáková A, Barnes C, Widen E, Kajantie E, Eriksson JG, Viikari J, Kähönen M, Lehtimäki T, Raitakari OT, Hartikainen AL, Ruokonen A, Pouta A, Jula A, Kangas AJ, Soininen P, Ala-Korpela M, Männistö S, Jousilahti P, Bonnycastle LL, Järvelin MR, Kuusisto J, Collins FS, Laakso M, Hurles ME, Palotie A, Peltonen L, Ripatti S, Salomaa VGenome-wide screen for metabolic syndrome susceptibility Loci reveals strong lipid gene contribution but no evidence for common genetic basis for clustering of metabolic syndrome traits.Circ Cardiovasc Genet.(2012-Apr-01)
    24. ^Zafar U, Khaliq S, Ahmad HU, Manzoor S, Lone KPMetabolic syndrome: an update on diagnostic criteria, pathogenesis, and genetic links.Hormones (Athens).(2018-Sep)
    25. ^Pi-Sunyer FXThe obesity epidemic: pathophysiology and consequences of obesity.Obes Res.(2002-Dec)
    26. ^André Tchernof, Jean-Pierre DesprésPathophysiology of human visceral obesity: an updatePhysiol Rev.(2013 Jan)
    27. ^Hydes T, Alam U, Cuthbertson DJThe Impact of Macronutrient Intake on Non-alcoholic Fatty Liver Disease (NAFLD): Too Much Fat, Too Much Carbohydrate, or Just Too Many Calories?Front Nutr.(2021)
    28. ^Ford ES, Li C, Sattar NMetabolic syndrome and incident diabetes: current state of the evidence.Diabetes Care.(2008-Sep)
    29. ^Ford ESRisks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence.Diabetes Care.(2005-Jul)
    30. ^Gang Hu, Qing Qiao, Jaakko Tuomilehto, Beverley Balkau, Knut Borch-Johnsen, Kalevi Pyorala, DECODE Study GroupPrevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and womenArch Intern Med.(2004 May 24)
    31. ^Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VMMetabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies.J Am Coll Cardiol.(2007-Jan-30)
    32. ^Behboudi-Gandevani S, Amiri M, Bidhendi Yarandi R, Noroozzadeh M, Farahmand M, Rostami Dovom M, Ramezani Tehrani FThe risk of metabolic syndrome in polycystic ovary syndrome: A systematic review and meta-analysis.Clin Endocrinol (Oxf).(2018-02)
    33. ^Otaghi M, Azami M, Khorshidi A, Borji M, Tardeh ZThe association between metabolic syndrome and polycystic ovary syndrome: A systematic review and meta-analysis.Diabetes Metab Syndr.(2019)
    34. ^Shen X, Wang Y, Zhao R, Wan Q, Wu Y, Zhao L, Wu XMetabolic syndrome and the risk of colorectal cancer: a systematic review and meta-analysis.Int J Colorectal Dis.(2021-Oct)
    35. ^Bhandari R, Kelley GA, Hartley TA, Rockett IRMetabolic syndrome is associated with increased breast cancer risk: a systematic review with meta-analysis.Int J Breast Cancer.(2014)
    36. ^Ren H, Wang J, Gao Y, Yang F, Huang WMetabolic syndrome and liver-related events: a systematic review and meta-analysis.BMC Endocr Disord.(2019-Apr-25)
    37. ^Esposito K, Chiodini P, Capuano A, Bellastella G, Maiorino MI, Giugliano DMetabolic syndrome and endometrial cancer: a meta-analysis.Endocrine.(2014-Feb)

    Examine Database References

    1. Insulin Resistance - Kelsey Gabel, Kristin K Hoddy, Nicole Haggerty, Jeehee Song, Cynthia M Kroeger, John F Trepanowski, Satchidananda Panda, Krista A VaradyEffects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: A pilot studyNutr Healthy Aging.(2018 Jun 15)
    2. Insulin Resistance - Sheida Zeraattalab-Motlagh, Ahmad Jayedi, Sakineh Shab-BidarThe effects of resveratrol supplementation in patients with type 2 diabetes, metabolic syndrome, and nonalcoholic fatty liver disease: an umbrella review of meta-analyses of randomized controlled trialsAm J Clin Nutr.(2021 Nov 8)
    3. Insulin Resistance - Consolato Sergi, Bonnie Chiu, Joseph Feulefack, Fan Shen, Brian ChiuUsefulness of resveratrol supplementation in decreasing cardiometabolic risk factors comparing subjects with metabolic syndrome and healthy subjects with or without obesity: meta-analysis using multinational, randomised, controlled trialsArch Med Sci Atheroscler Dis.(2020 May 30)
    4. Insulin Resistance - Liu K, Zhou R, Wang B, Mi MTEffect of resveratrol on glucose control and insulin sensitivity: a meta-analysis of 11 randomized controlled trials.Am J Clin Nutr.(2014-Jun)
    5. Insulin Resistance - Guo XF, Li JM, Tang J, Li DEffects of resveratrol supplementation on risk factors of non-communicable diseases: A meta-analysis of randomized controlled trials.Crit Rev Food Sci Nutr.(2018)
    6. High-density lipoprotein (HDL) - Maryam Akbari, Omid Reza Tamtaji, Kamran B Lankarani, Reza Tabrizi, Ehsan Dadgostar, Neda Haghighat, Fariba Kolahdooz, Amir Ghaderi, Mohammad Ali Mansournia, Zatollah AsemiThe effects of resveratrol on lipid profiles and liver enzymes in patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trialsLipids Health Dis.(2020 Feb 17)
    7. High-density lipoprotein (HDL) - Qian Zhou, Yanmei Wang, Xuke Han, Shunlian Fu, Chan Zhu, Qiu ChenEfficacy of Resveratrol Supplementation on Glucose and Lipid Metabolism: A Meta-Analysis and Systematic ReviewFront Physiol.(2022 Mar 31)
    8. High-density lipoprotein (HDL) - Sahebkar AEffects of resveratrol supplementation on plasma lipids: a systematic review and meta-analysis of randomized controlled trials.Nutr Rev.(2013-Dec)
    9. High-density lipoprotein (HDL) - Cao X, Liao W, Xia H, Wang S, Sun GThe Effect of Resveratrol on Blood Lipid Profile: A Dose-Response Meta-Analysis of Randomized Controlled Trials.Nutrients.(2022-Sep-11)
    10. Body Fat - Mousavi SM, Milajerdi A, Sheikhi A, Kord-Varkaneh H, Feinle-Bisset C, Larijani B, Esmaillzadeh AResveratrol supplementation significantly influences obesity measures: a systematic review and dose-response meta-analysis of randomized controlled trials.Obes Rev.(2019-Mar)
    11. Blood Pressure - Samuel R Weaver, Catarina Rendeiro, Helen M McGettrick, Andrew Philp, Samuel J E LucasFine wine or sour grapes? A systematic review and meta-analysis of the impact of red wine polyphenols on vascular healthEur J Nutr.(2021 Feb)
    12. Blood Pressure - Akbari M, Tamtaji OR, Lankarani KB, Tabrizi R, Dadgostar E, Kolahdooz F, Jamilian M, Mirzaei H, Asemi ZThe Effects of Resveratrol Supplementation on Endothelial Function and Blood Pressures Among Patients with Metabolic Syndrome and Related Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.High Blood Press Cardiovasc Prev.(2019-Aug)
    13. Blood Pressure - Liu Y, Ma W, Zhang P, He S, Huang DEffect of resveratrol on blood pressure: a meta-analysis of randomized controlled trials.Clin Nutr.(2015-Feb)
    14. Creatinine - Abdollahi S, Vajdi M, Meshkini F, Vasmehjani AA, Sangsefidi ZS, Clark CCT, Soltani SResveratrol may mildly improve renal function in the general adult population: A systematic review and meta-analysis of randomized controlled clinical trials.Nutr Res.(2023-May)
    15. Adiponectin - Mohammadi-Sartang M, Mazloom Z, Sohrabi Z, Sherafatmanesh S, Barati-Boldaji RResveratrol supplementation and plasma adipokines concentrations? A systematic review and meta-analysis of randomized controlled trials.Pharmacol Res.(2017-Mar)
    16. C-Reactive Protein (CRP) - Armita Mahdavi Gorabi, Saeed Aslani, Danyal Imani, Bahman Razi, Thozhukat Sathyapalan, Amirhossein SahebkarEffect of resveratrol on C-reactive protein: An updated meta-analysis of randomized controlled trialsPhytother Res.(2021 Dec)
    17. C-Reactive Protein (CRP) - Haghighatdoost F, Hariri MCan resveratrol supplement change inflammatory mediators? A systematic review and meta-analysis on randomized clinical trials.Eur J Clin Nutr.(2019-Mar)
    18. C-Reactive Protein (CRP) - Tabrizi R, Tamtaji OR, Lankarani KB, Mirhosseini N, Akbari M, Dadgostar E, Peymani P, Asemi ZThe effects of resveratrol supplementation on biomarkers of inflammation and oxidative stress among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials.Food Funct.(2018-Dec-13)
    19. Interleukin 6 - Melodi Omraninava, Bahman Razi, Saeed Aslani, Danyal Imani, Tannaz Jamialahmadi, Amirhossein SahebkarEffect of resveratrol on inflammatory cytokines: A meta-analysis of randomized controlled trialsEur J Pharmacol.(2021 Oct 5)
    20. Plasminogen Inhibitor-1 - Mohammadipoor N, Shafiee F, Rostami A, Kahrizi MS, Soleimanpour H, Ghodsi M, Ansari MJ, Bokov DO, Jannat B, Mosharkesh E, Pour Abbasi MSResveratrol supplementation efficiently improves endothelial health: A systematic review and meta-analysis of randomized controlled trials.Phytother Res.(2022-Sep)
    21. Insulin Resistance - Zamani M, Zarei M, Nikbaf-Shandiz M, Hosseini S, Shiraseb F, Asbaghi OThe effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis.Front Nutr.(2022)
    22. High-density lipoprotein (HDL) - Pérez-Rubio KG, González-Ortiz M, Martínez-Abundis E, Robles-Cervantes JA, Espinel-Bermúdez MCEffect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretionMetab Syndr Relat Disord.(2013 Oct)
    23. Insulin Resistance - Amirani E, Milajerdi A, Reiner Ž, Mirzaei H, Mansournia MA, Asemi ZEffects of whey protein on glycemic control and serum lipoproteins in patients with metabolic syndrome and related conditions: a systematic review and meta-analysis of randomized controlled clinical trials.Lipids Health Dis.(2020-Sep-21)
    24. High-density lipoprotein (HDL) - Badely M, Sepandi M, Samadi M, Parastouei K, Taghdir MThe effect of whey protein on the components of metabolic syndrome in overweight and obese individuals; a systematic review and meta-analysis.Diabetes Metab Syndr.(2019)
    25. High-density lipoprotein (HDL) - .(2024-06-15)
    26. Insulin - Smedegaard S, Kampmann U, Ovesen PG, Støvring H, Rittig NWhey Protein Premeal Lowers Postprandial Glucose Concentrations in Adults Compared with Water-The Effect of Timing, Dose, and Metabolic Status: a Systematic Review and Meta-analysis.Am J Clin Nutr.(2023-Aug)
    27. Insulin Resistance - Kastorini, C.M., et al.The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individualsJ Am Coll Cardiol.(2011-03-15)
    28. High-density lipoprotein (HDL) - Papadaki A, Nolen-Doerr E, Mantzoros CSThe Effect of the Mediterranean Diet on Metabolic Health: A Systematic Review and Meta-Analysis of Controlled Trials in Adults.Nutrients.(2020-Oct-30)
    29. High-density lipoprotein (HDL) - Garcia M, Bihuniak JD, Shook J, Kenny A, Kerstetter J, Huedo-Medina TBThe Effect of the Traditional Mediterranean-Style Diet on Metabolic Risk Factors: A Meta-Analysis.Nutrients.(2016-Mar-15)
    30. Fasting Glucose - Jing T, Zhang S, Bai M, Chen Z, Gao S, Li S, Zhang JEffect of Dietary Approaches on Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review with Network Meta-Analysis of Randomized Trials.Nutrients.(2023-Jul-15)
    31. Endothelial Function - Shannon OM, Mendes I, Köchl C, Mazidi M, Ashor AW, Rubele S, Minihane AM, Mathers JC, Siervo MMediterranean Diet Increases Endothelial Function in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.J Nutr.(2020-May-01)
    32. High-density lipoprotein (HDL) - Najmi A, Nasiruddin M, Khan RA, Haque SFEffect of Nigella sativa oil on various clinical and biochemical parameters of insulin resistance syndromeInt J Diabetes Dev Ctries.(2008 Jan)
    33. High-density lipoprotein (HDL) - Shabani M, Ghavidel F, Rajabian A, Homayouni-Tabrizi M, Jamialahmadi T, Hosseini H, Sahebkar AEffect of Nigella sativa Consumption on Lipid Profile and Glycemic Index in Patients with Metabolic Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Curr Med Chem.(2024-Jan-23)
    34. Oxidative Stress Biomarkers - Kavyani Z, Musazadeh V, Golpour-Hamedani S, Moridpour AH, Vajdi M, Askari GThe effect of Nigella sativa (black seed) on biomarkers of inflammation and oxidative stress: an updated systematic review and meta-analysis of randomized controlled trials.Inflammopharmacology.(2023-Jun)
    35. High-density lipoprotein (HDL) - Babak Roshanravan, Saeed Samarghandian, Milad Ashrafizadeh, Alireza Amirabadizadeh, Farhad Saeedi, Tahereh FarkhondehMetabolic Impact of Saffron and Crocin: An Updated Systematic and Meta-Analysis of Randomised Clinical TrialsArch Physiol Biochem.(2020 Feb 4)
    36. High-density lipoprotein (HDL) - Tayebe Kermani, Maedeh Zebarjadi, Hassan Mehrad-Majd, Seyed-Reza Mirhafez, Maryam Shemshian, Faezeh Ghasemi, Elham Mohammadzadeh, Seyed Hadi Mousavi, Abdolreza Norouzy, Toktam Moghiman, Akram Sadeghi, Gordon Ferns, Amir Avan, Elaheh Mahdipour, Majid Ghayour-MobarhanAnti-Inflammatory Effect of Crocus sativus on Serum Cytokine Levels in Subjects with Metabolic Syndrome: A Randomized, Double-Blind, Placebo- Controlled TrialCurr Clin Pharmacol.(2017)
    37. High-density lipoprotein (HDL) - Soukhtanloo M, et alEffect of saffron on serum leptin levels in patients with metabolic syndrome, a double-blind, randomized and placebo-controlled trial studyProg Nutr.()
    38. Oxidative Stress Biomarkers - Tayyebeh Kermani, Seyyed Hadi Mousavi, Maryam Shemshian, Abdolreza Norouzy, Mohsen Mazidi, Atefeh Moezzi, Toktam Moghiman, Majid Ghayour-Mobarhan, Gordon A FernsSaffron supplements modulate serum pro-oxidant-antioxidant balance in patients with metabolic syndrome: A randomized, placebo-controlled clinical trialAvicenna J Phytomed.(Sep-Oct 2015)
    39. C-Reactive Protein (CRP) - Asbaghi O, Sadeghian M, Sadeghi O, Rigi S, Tan SC, Shokri A, Mousavi SMEffects of saffron (Crocus sativus L.) supplementation on inflammatory biomarkers: A systematic review and meta-analysis.Phytother Res.(2021-Jan)
    40. High-density lipoprotein (HDL) - Mansouri M, Nayebi N, Keshtkar A, Hasani-Ranjbar S, Taheri E, Larijani BThe effect of 12 weeks Anethum graveolens (dill) on metabolic markers in patients with metabolic syndrome; a randomized double blind controlled trialDaru.(2012 Oct 4)
    41. High-density lipoprotein (HDL) - Mousavi SM, Beatriz Pizarro A, Akhgarjand C, Bagheri A, Persad E, Karimi E, Wong A, Jayedi AThe effects of Anethum graveolens (dill) supplementation on lipid profile and glycemic control: a systematic review and meta-analysis of randomized controlled trials.Crit Rev Food Sci Nutr.(2022)
    42. High-density lipoprotein (HDL) - Hana Kahleova, James McCann, Jihad Alwarith, Emilie Rembert, Andrea Tura, Richard Holubkov, Neal D BarnardA plant-based diet in overweight adults in a 16-week randomized clinical trial: The role of dietary acid loadClin Nutr ESPEN.(2021 Aug)
    43. Weight - Hana Kahleova, Kitt Falk Petersen, Gerald I Shulman, Jihad Alwarith, Emilie Rembert, Andrea Tura, Martin Hill, Richard Holubkov, Neal D BarnardEffect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults: A Randomized Clinical TrialJAMA Netw Open.(2020 Nov 2)
    44. High-density lipoprotein (HDL) - Arpita Basu, Mei Du, Misti J Leyva, Karah Sanchez, Nancy M Betts, Mingyuan Wu, Christopher E Aston, Timothy J LyonsBlueberries decrease cardiovascular risk factors in obese men and women with metabolic syndromeJ Nutr.(2010 Sep)
    45. High-density lipoprotein (HDL) - Wan Y, Vinson JA, Etherton TD, Proch J, Lazarus SA, Kris-Etherton PMEffects of cocoa powder and dark chocolate on LDL oxidative susceptibility and prostaglandin concentrations in humansAm J Clin Nutr.(2001 Nov)
    46. High-density lipoprotein (HDL) - Davison K, Coates AM, Buckley JD, Howe PREffect of cocoa flavanols and exercise on cardiometabolic risk factors in overweight and obese subjectsInt J Obes (Lond).(2008 Aug)
    47. High-density lipoprotein (HDL) - Eric W Manheimer, Esther J van Zuuren, Zbys Fedorowicz, Hanno PijlPaleolithic nutrition for metabolic syndrome: systematic review and meta-analysisAm J Clin Nutr.(2015 Oct)
    48. High-density lipoprotein (HDL) - Park BJ, Lee YJ, Lee HR, Jung DH, Na HY, Kim HB, Shim JYEffects of Korean Red Ginseng on Cardiovascular Risks in Subjects with Metabolic Syndrome: a Double-blind Randomized Controlled StudyKorean J Fam Med.(2012 Jul)
    49. High-density lipoprotein (HDL) - Rizza S, Muniyappa R, Iantorno M, Kim JA, Chen H, Pullikotil P, Senese N, Tesauro M, Lauro D, Cardillo C, Quon MJCitrus polyphenol hesperidin stimulates production of nitric oxide in endothelial cells while improving endothelial function and reducing inflammatory markers in patients with metabolic syndromeJ Clin Endocrinol Metab.(2011 May)
    50. High-density lipoprotein (HDL) - Amin F, Islam N, Anila N, Gilani AHClinical efficacy of the co-administration of Turmeric and Black seeds (Kalongi) in metabolic syndrome - a double blind randomized controlled trial - TAK-MetS trialComplement Ther Med.(2015 Apr)
    51. High-density lipoprotein (HDL) - Panahi Y, Khalili N, Hosseini MS, Abbasinazari M, Sahebkar ALipid-modifying effects of adjunctive therapy with curcuminoids-piperine combination in patients with metabolic syndrome: results of a randomized controlled trialComplement Ther Med.(2014 Oct)
    52. Blood Pressure - Panahi Y, Hosseini MS, Khalili N, Naimi E, Majeed M, Sahebkar AAntioxidant and anti-inflammatory effects of curcuminoid-piperine combination in subjects with metabolic syndrome: A randomized controlled trial and an updated meta-analysisClin Nutr.(2015 Dec)
    53. Weight - Akbari M, Lankarani KB, Tabrizi R, Ghayour-Mobarhan M, Peymani P, Ferns G, Ghaderi A, Asemi ZThe Effects of Curcumin on Weight Loss Among Patients With Metabolic Syndrome and Related Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Front Pharmacol.(2019)
    54. Oxidative Stress Biomarkers - Tabrizi R, Vakili S, Akbari M, Mirhosseini N, Lankarani KB, Rahimi M, Mobini M, Jafarnejad S, Vahedpoor Z, Asemi ZThe effects of curcumin-containing supplements on biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis of randomized controlled trials.Phytother Res.(2019-Feb)
    55. High-density lipoprotein (HDL) - Reyhaneh Yousefi, Azadeh Mottaghi, Atoosa SaidpourSpirulina platensis effectively ameliorates anthropometric measurements and obesity-related metabolic disorders in obese or overweight healthy individuals: A randomized controlled trialComplement Ther Med.(2018 Oct)
    56. High-density lipoprotein (HDL) - Zahra Hamedifard, Alireza Milajerdi, Željko Reiner, Mohsen Taghizadeh, Fariba Kolahdooz, Zatollah AsemiThe effects of spirulina on glycemic control and serum lipoproteins in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trialsPhytother Res.(2019 Oct)
    57. High-density lipoprotein (HDL) - Mohamed Rafiullah, Mohthash Musambil, Satish Kumar DavidEffect of a very low-carbohydrate ketogenic diet vs recommended diets in patients with type 2 diabetes: a meta-analysisNutr Rev.(2021 Aug 2)
    58. High-density lipoprotein (HDL) - Parker N Hyde, Teryn N Sapper, Christopher D Crabtree, Richard A LaFountain, Madison L Bowling, Alex Buga, Brandon Fell, Fionn T McSwiney, Ryan M Dickerson, Vincent J Miller, Debbie Scandling, Orlando P Simonetti, Stephen D Phinney, William J Kraemer, Sarah A King, Ronald M Krauss, Jeff S VolekDietary carbohydrate restriction improves metabolic syndrome independent of weight lossJCI Insight.(2019 Jun 20)
    59. High-density lipoprotein (HDL) - Parry-Strong A, Wright-McNaughton M, Weatherall M, Hall RM, Coppell KJ, Barthow C, Krebs JDVery low carbohydrate (ketogenic) diets in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials.Diabetes Obes Metab.(2022-Dec)
    60. High-density lipoprotein (HDL) - Zhou C, Wang M, Liang J, He G, Chen NKetogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails.Int J Environ Res Public Health.(2022 Aug 22)
    61. High-density lipoprotein (HDL) - Jun-jie Zhang, Zhi-bing Wu, You-jin Cai, Bin Ke, Ying-juan Huang, Chao-ping Qiu, Yu-bing Yang, Lan-ying Shi, Jian QinL-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled studyNutr J.(2014 Nov 26)
    62. High-density lipoprotein (HDL) - Munji Choi, Seongmin Park, Myoungsook LeeL-Carnitine's Effect on the Biomarkers of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsNutrients.(2020 Sep 12)
    63. Total cholesterol - Johri A, et alProgression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndromeNutr Metab..()
    64. Blood Pressure - Ruggenenti P, Cattaneo D, Loriga G, Ledda F, Motterlini N, Gherardi G, Orisio S, Remuzzi GAmeliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapyHypertension.(2009 Sep)
    65. High-density lipoprotein (HDL) - Schwab U, Alfthan G, Aro A, Uusitupa MLong-term effect of betaine on risk factors associated with the metabolic syndrome in healthy subjectsEur J Clin Nutr.(2011 Jan)
    66. Homocysteine - Alfthan G, Tapani K, Nissinen K, Saarela J, Aro AThe effect of low doses of betaine on plasma homocysteine in healthy volunteersBr J Nutr.(2004 Oct)
    67. High-density lipoprotein (HDL) - Ezgi Bellikci-Koyu, Banu Pınar Sarer-Yurekli, Yakut Akyon, Fadime Aydin-Kose, Cem Karagozlu, Ahmet Gokhan Ozgen, Annika Brinkmann, Andreas Nitsche, Koray Ergunay, Engin Yilmaz, Zehra BuyuktuncerEffects of Regular Kefir Consumption on Gut Microbiota in Patients with Metabolic Syndrome: A Parallel-Group, Randomized, Controlled StudyNutrients.(2019 Sep 4)
    68. High-density lipoprotein (HDL) - Ghizi ACdS et alKefir improves blood parameters and reduces cardiovascular risks in patients with metabolic syndromePharmaNutrition.()
    69. High-density lipoprotein (HDL) - Laso N, Brugué E, Vidal J, Ros E, Arnaiz JA, Carné X, Vidal S, Mas S, Deulofeu R, Lafuente AEffects of milk supplementation with conjugated linoleic acid (isomers cis-9, trans-11 and trans-10, cis-12) on body composition and metabolic syndrome componentsBr J Nutr.(2007 Oct)
    70. High-density lipoprotein (HDL) - de Bock M, Derraik JG, Brennan CM, Biggs JB, Morgan PE, Hodgkinson SC, Hofman PL, Cutfield WSOlive (Olea europaea L.) Leaf Polyphenols Improve Insulin Sensitivity in Middle-Aged Overweight Men: A Randomized, Placebo-Controlled, Crossover TrialPLoS One.(2013)
    71. High-density lipoprotein (HDL) - Gómez-Arbeláez D, Lahera V, Oubiña P, Valero-Muñoz M, de Las Heras N, Rodríguez Y, García RG, Camacho PA, López-Jaramillo PAged garlic extract improves adiponectin levels in subjects with metabolic syndrome: a double-blind, placebo-controlled, randomized, crossover studyMediators Inflamm.(2013)
    72. High-density lipoprotein (HDL) - Gurrola-Díaz CM, García-López PM, Sánchez-Enríquez S, Troyo-Sanromán R, Andrade-González I, Gómez-Leyva JFEffects of Hibiscus sabdariffa extract powder and preventive treatment (diet) on the lipid profiles of patients with metabolic syndrome (MeSy)Phytomedicine.(2010 Jun)
    73. High-density lipoprotein (HDL) - Sivaprakasapillai B, Edirisinghe I, Randolph J, Steinberg F, Kappagoda TEffect of grape seed extract on blood pressure in subjects with the metabolic syndromeMetabolism.(2009 Dec)
    74. High-density lipoprotein (HDL) - Iqbal N, Cardillo S, Volger S, Bloedon LT, Anderson RA, Boston R, Szapary POChromium picolinate does not improve key features of metabolic syndrome in obese nondiabetic adultsMetab Syndr Relat Disord.(2009 Apr)
    75. High-density lipoprotein (HDL) - Ali A, Ma Y, Reynolds J, Wise JP Sr, Inzucchi SE, Katz DLChromium effects on glucose tolerance and insulin sensitivity in persons at risk for diabetes mellitusEndocr Pract.(2011 Jan-Feb)
    76. Blood Pressure - Ghanbari M, Amini MR, Djafarian K, Shab-Bidar SThe effects of chromium supplementation on blood pressure: a systematic review and meta-analysis of randomized clinical trials.Eur J Clin Nutr.(2022-Mar)
    77. Oxidative Stress Biomarkers - Morvaridzadeh M, Estêvão MD, Qorbani M, Heydari H, Hosseini AS, Fazelian S, Belančić A, Persad E, Rezamand G, Heshmati JThe effect of chromium intake on oxidative stress parameters: A systematic review and meta-analysis.J Trace Elem Med Biol.(2022-Jan)
    78. C-Reactive Protein (CRP) - Zhang X, Cui L, Chen B, Xiong Q, Zhan Y, Ye J, Yin QEffect of chromium supplementation on hs-CRP, TNF-α and IL-6 as risk factor for cardiovascular diseases: A meta-analysis of randomized-controlled trials.Complement Ther Clin Pract.(2021-Feb)
    79. Apolipoprotein B - Shahinfar H, Amini MR, Sheikhhossein F, Djafari F, Jafari A, Shab-Bidar SThe effect of chromium supplementation on apolipoproteins: A systematic review and meta-analysis of randomized clinical trials.Clin Nutr ESPEN.(2020-Dec)
    80. High-density lipoprotein (HDL) - Maeba R, Hara H, Ishikawa H, Hayashi S, Yoshimura N, Kusano J, Takeoka Y, Yasuda D, Okazaki T, Kinoshita M, Teramoto TMyo-inositol treatment increases serum plasmalogens and decreases small dense LDL, particularly in hyperlipidemic subjects with metabolic syndromeJ Nutr Sci Vitaminol (Tokyo).(2008 Jun)
    81. High-density lipoprotein (HDL) - Santamaria A, Giordano D, Corrado F, Pintaudi B, Interdonato ML, Vieste GD, Benedetto AD, D'Anna ROne-year effects of myo-inositol supplementation in postmenopausal women with metabolic syndromeClimacteric.(2012 Oct)
    82. Blood Pressure - M Nordio, E ProiettiThe combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation aloneEur Rev Med Pharmacol Sci.(2012 May)
    83. High-density lipoprotein (HDL) - Blond E, Rieusset J, Alligier M, Lambert-Porcheron S, Bendridi N, Gabert L, Chetiveaux M, Debard C, Chauvin MA, Normand S, Roth H, de Gouville AC, Krempf M, Vidal H, Goudable J, Laville M, “Niacin” Study GroupNicotinic acid effects on insulin sensitivity and hepatic lipid metabolism: an in vivo to in vitro studyHorm Metab Res.(2014 Jun)
    84. High-density lipoprotein (HDL) - Afitska K, Clavel J, Kisters K, Vormann J, Werner TMagnesium citrate supplementation decreased blood pressure and HbA1c in normomagnesemic subjects with metabolic syndrome: a 12-week, placebo-controlled, double-blinded pilot trial.Magnes Res.(2021-Aug-01)
    85. Triglycerides - Hashemipour M, Kelishadi R, Shapouri J, Sarrafzadegan N, Amini M, Tavakoli N, Movahedian-Attar A, Mirmoghtadaee P, Poursafa PEffect of zinc supplementation on insulin resistance and components of the metabolic syndrome in prepubertal obese childrenHormones (Athens).(2009 Oct-Dec)
    86. Oxidative Stress Biomarkers - Kara E, Gunay M, Cicioglu I, Ozal M, Kilic M, Mogulkoc R, Baltaci AKEffect of zinc supplementation on antioxidant activity in young wrestlersBiol Trace Elem Res.(2010 Apr)
    87. Blood Pressure - Simão AN, Lozovoy MA, Bahls LD, Morimoto HK, Simão TN, Matsuo T, Dichi IBlood pressure decrease with ingestion of a soya product (kinako) or fish oil in women with the metabolic syndrome: role of adiponectin and nitric oxideBr J Nutr.(2012 Feb 8)
    88. Blood Pressure - Sola S, Mir MQ, Cheema FA, Khan-Merchant N, Menon RG, Parthasarathy S, Khan BVIrbesartan and lipoic acid improve endothelial function and reduce markers of inflammation in the metabolic syndrome: results of the Irbesartan and Lipoic Acid in Endothelial Dysfunction (ISLAND) studyCirculation.(2005 Jan 25)
    89. Blood Pressure - Young JM, Florkowski CM, Molyneux SL, McEwan RG, Frampton CM, Nicholls MG, Scott RS, George PMA randomized, double-blind, placebo-controlled crossover study of coenzyme Q10 therapy in hypertensive patients with the metabolic syndromeAm J Hypertens.(2012 Feb)
    90. Weight - Arpita Basu, Karah Sanchez, Misti J Leyva, Mingyuan Wu, Nancy M Betts, Christopher E Aston, Timothy J LyonsGreen tea supplementation affects body weight, lipids, and lipid peroxidation in obese subjects with metabolic syndromeJ Am Coll Nutr.(2010 Feb)
    91. Weight - Fujioka K, Greenway F, Sheard J, Ying YThe effects of grapefruit on weight and insulin resistance: relationship to the metabolic syndromeJ Med Food.(2006 Spring)
    92. Liver Enzymes - Samira Yarmohammadi, Reza Hosseini-Ghatar, Sahar Foshati, Mojgan Moradi, Niloofar Hemati, Sajjad Moradi, Mohammad Ali Hojjati Kermani, Mohammad Hosein Farzaei, Haroon KhanEffect of Chlorella vulgaris on Liver Function Biomarkers: a Systematic Review and Meta-AnalysisClin Nutr Res.(2021 Jan 29)
    93. Oxidative Stress Biomarkers - Wei Y, Zhang X, Meng Y, Wang Q, Xu H, Chen LThe Effects of Resistant Starch on Biomarkers of Inflammation and Oxidative Stress: A Systematic Review and Meta-Analysis.Nutr Cancer.(2022)
    94. Adiponectin - Jalili C, Pezeshki M, Askarpour M, Marx W, Hassani B, Hadi A, Ghaedi EThe effect of flaxseed supplementation on circulating adiponectin and leptin concentration in adults: A systematic review and meta-analysis of randomized controlled trials.Phytother Res.(2020 Jul)
    95. C-Reactive Protein (CRP) - Tamtaji OR, Milajerdi A, Reiner Ž, Dadgostar E, Amirani E, Asemi Z, Mirsafaei L, Mansournia MA, Dana PM, Sadoughi F, Hallajzadeh JEffects of flaxseed oil supplementation on biomarkers of inflammation and oxidative stress in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials.Clin Nutr ESPEN.(2020 Dec)
    96. C-Reactive Protein (CRP) - Jiang Z, Qu H, Chen K, Gao ZBeneficial effects of folic acid on inflammatory markers in the patients with metabolic syndrome: Meta-analysis and meta-regression of data from 511 participants in 10 randomized controlled trials.Crit Rev Food Sci Nutr.(2022-Dec-28)
    97. Risk Of Cardiovascular Disease - Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala NB, Clarke A, Franco OHLevels of vitamin D and cardiometabolic disorders: systematic review and meta-analysisMaturitas.(2010 Mar)
    98. Risk Of Cardiovascular Disease - Semnani-Azad Z, Khan TA, Blanco Mejia S, de Souza RJ, Leiter LA, Kendall CWC, Hanley AJ, Sievenpiper JLAssociation of Major Food Sources of Fructose-Containing Sugars With Incident Metabolic Syndrome: A Systematic Review and Meta-analysis.JAMA Netw Open.(2020 Jul 1)