BACKGROUND Metabolic syndrome is characterised by a clustering of metabolic risk factors including abdominal obesity, raised triglycerides, lowered HDL cholesterol, hypertension and impaired glucose tolerance. Multifaceted lifestyle interventions including diet and exercise are recommended as the first-line treatment for the metabolic syndrome. OBJECTIVE To investigate the effects of lifestyle interventions that include both diet interventions and supervised exercise on outcomes for people with metabolic syndrome. METHODS A systematic review and meta-regression was conducted. PubMed, EMBASE, MEDLINE and CINAHL were searched from the earliest date possible until November 2018 to identify randomised controlled trials examining the effects of lifestyle interventions compared to usual care on patient health outcomes and components of metabolic syndrome. Post-intervention means and standard deviations were pooled using inverse variance methods and random-effects models to calculate mean differences (MD), standardised mean differences (SMD) and 95% confidence intervals (CI). RESULTS Searching identified 2598 articles, of which 15 articles reporting data from 10 trials, with 1160 participants were included in this review. Compared to usual care, supervised lifestyle intervention demonstrated significant improvements in all but one of the components of metabolic syndrome. Reductions were seen in waist circumference (-4.9 cm, 95%CI -8.0 to -1.7), systolic blood pressure (-6.5 mmHg, 95%CI -10.7 to -2.3), diastolic blood pressure (-1.9 mmHg, 95%CI -3.6 to -0.2), triglycerides (SMD -0.46, 95%CI -0.88 to -0.04) and fasting glucose (SMD -0.68, 95%CI -1.20 to -0.15). Prevalence of metabolic syndrome was reduced by 39% in intervention group participants compared to control group participants (Risk Ratio 0.61, 95%CI 0.38 to 0.96). Improvements in quality of life were not statistically significant. CONCLUSION There is low to moderate quality evidence that supervised multifaceted lifestyle intervention improves multiple risk factors of metabolic syndrome, as well as reducing prevalence of the disease. Health services should consider implementing lifestyle intervention programs for people with metabolic syndrome to improve health outcomes and prevent progression to chronic disease.

中文翻译：

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对代谢综合征患者的有监督的生活方式干预可改善结果并减少代谢综合征的个体危险因素：系统的回顾和荟萃分析。

背景技术代谢综合征的特征在于包括腹部肥胖，甘油三酸酯升高，HDL胆固醇降低，高血压和葡萄糖耐量降低在内的代谢危险因素的聚集。建议将饮食和运动等多方面的生活方式干预作为代谢综合征的一线治疗方法。目的探讨包括饮食干预和监督运动在内的生活方式干预对代谢综合征患者结局的影响。方法进行系统评价和荟萃回归。PubMed，EMBASE，从最早的可能日期直到2018年11月，对MEDLINE和CINAHL进行了搜索，以鉴定随机对照试验，该试验比较了生活方式干预与常规护理相比对患者健康结局和代谢综合征组成部分的影响。使用逆方差方法和随机效应模型汇总干预后的均值和标准差，以计算均值差（MD），标准化均值差（SMD）和95％置信区间（CI）。结果搜索确定了2598篇文章，其中15篇报道了10项试验的数据，共有1160名参与者。与常规护理相比，有监督的生活方式干预显示除代谢综合征的一种成分外，所有其他方面均得到了显着改善。腰围（-4.9 cm，95％CI -8）减少。0至-1.7），收缩压（-6.5 mmHg，95％CI -10.7至-2.3），舒张压（-1.9 mmHg，95％CI -3.6至-0.2），甘油三酸酯（SMD -0.46，95％ CI -0.88至-0.04）和空腹血糖（SMD -0.68，95％CI -1.20至-0.15）。与对照组相比，干预组参与者的代谢综合征患病率降低了39％（风险比0.61，95％CI为0.38至0.96）。生活质量的改善在统计学上不显着。结论有低至中等质量的证据表明，有监督的多方面生活方式干预可改善代谢综合征的多种危险因素，并降低疾病的流行率。卫生服务部门应考虑为代谢综合征患者实施生活方式干预计划，以改善健康状况并防止进展为慢性疾病。收缩压（-6.5 mmHg，95％CI -10.7至-2.3），舒张压（-1.9 mmHg，95％CI -3.6至-0.2），甘油三酸酯（SMD -0.46，95％CI -0.88至-0.04 ）和空腹血糖（SMD -0.68，95％CI -1.20至-0.15）。与对照组相比，干预组参与者的代谢综合征患病率降低了39％（风险比0.61，95％CI为0.38至0.96）。生活质量的改善在统计学上不显着。结论有低至中等质量的证据表明，有监督的多方面生活方式干预可改善代谢综合征的多种危险因素，并降低疾病的流行率。卫生服务部门应考虑为代谢综合征患者实施生活方式干预计划，以改善健康状况并防止进展为慢性疾病。收缩压（-6.5 mmHg，95％CI -10.7至-2.3），舒张压（-1.9 mmHg，95％CI -3.6至-0.2），甘油三酸酯（SMD -0.46，95％CI -0.88至-0.04 ）和空腹血糖（SMD -0.68，95％CI -1.20至-0.15）。与对照组相比，干预组参与者的代谢综合征患病率降低了39％（风险比0.61，95％CI为0.38至0.96）。生活质量的改善在统计学上不显着。结论有低至中等质量的证据表明，有监督的多方面生活方式干预可改善代谢综合征的多种危险因素，并降低疾病的流行率。卫生服务部门应考虑为代谢综合征患者实施生活方式干预计划，以改善健康状况并防止进展为慢性疾病。