Effectiveness of interventions for reducing diabetes and cardiovascular disease risk in people with metabolic syndrome: systematic review and mixed treatment comparison meta-analysis
Diabetes, Obesity and Metabolism, 06/21/2012
Evidence Based Medicine
Dunkley AJ et al. - 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.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.
- 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%.