Meta-analysis/systematic review of interventions against metabolic syndrome

The metabolic syndrome is a combination of risk factors of metabolic origin such as abdominal obesity, atherogenic dyslipidemia (elevated apolipoprotein B, elevated triglyceride, small LDL particles, low HDL cholesterol), raised blood pressure, insulin resistance (elevated plasma glucose either as pre-diabetes or diabetes), and prothrombotic and proinflammatory states.^1,2 Metabolic syndrome also named as ‘‘syndrome X”, “Insulin Resistance Syndrome” is accompanied by increased risk for atherosclerotic cardiovascular disease³ and type 2 diabetes.²  South Asian populations are inherently at a greater risk of cardiovascular diseases and diabetes.^4,5  Hospital based studies in Pakistan have documented a frequency of 35-37% of the metabolic syndrome among coronary heart disease patients.^6,7 Frequency of the metabolic syndrome in type 2 diabetic patients in Pakistan ranges from 80%-86%.^8,9
Although the pathogenesis of the metabolic syndrome is multifactorial^1,2 obesity and insulin resistance are recognized as the two major underlying risk factors.²
Research into the genetic and molecular basis of Insulin resistance is also being done throughout the world.           
Until now clinicians have resorted to treatment of cardiovascular diseases with expensive surgical and medical modalities. The expensive diagnostic and therapeutic treatment of cardiovascular diseases is out of reach of the common man. It is high time for all the countries, particularly the developing world, that we adopt preventive and promotive approach to tackle the problem of diabetes and cardiovascular diseases.

In the proposed meta-analysis/systematic review we would present the interventions which have been tried as Randomized controlled trial plus observational studies to tackle metabolic syndrome. Specifically we would look in to interventions which would particularly address insulin resistance, obesity and hypertriglyceridaemia. These interventions would range from life style interventions, dietary interventions, pharmacotherapy to gene therapy. Evidence would be sought from medline, Cochrane database, WHO-HINARI and other known Research databases.