Background and Aims

Metabolic syndrome is a multifactorial heterogenous disorder & marked variability in cholesterol, WC ,BP, lipid profile & FPG has been characterised as components of metabolic syndrome. Metformin and Pioglitazone have been known to decrease insulin resistance. Rosuvastatin targets hyperlipidemia, major component of metabolic syndrome . Statins have pleiotropic effects such as reducing oxidative stress and modulating inflammatory responses.Thus, these drugs may potentially target the underlying pathophysiology and till date there is no randomized controlled trial comparing the effects of these drugs together on various components of metabolic syndrome. Comparative effects of these treatments on markers of insulin resistance and inflammation have not yet been reported.

Aims:- To evaluate and compare the effects of metformin, pioglitazone and rosuvastatin on various parameters of metabolic syndrome & on levels of insulin sensitizers (adiponectin) and markers of inflammation (hsCRP) in cases with MetS.

Methods

The current study was planned to evaluate & compare various potential treatments for the patients of metabolic syndrome. A prospective , open label, parallel group & randomized control trial of 12 weeks study duration was selected in which patients were randomly assigned in 4 groups to receive diet & lifestyle modification, Metformin, Pioglitazone, Rosuvastatin.

Results

There was no significant difference between the groups in any baseline parameter & all 4 groups were comparable to each other at baseline.

EFFECT ON BIOCHEMICAL PARAMETERS :-

Conclusions

Only Rosuvastatin brought about significant increase in serum HDL which is a major marker of cardiovascular risk. Pioglitazone & Rosuvastatin were better than Metformin & lifestyle modification in reduction of serum triglycerides.