Table 1. Definition of study outcome measures.

Study outcome	Acceptable outcome measures in individual studies for inclusion in the meta-analysis
Diabetes mellitus	ADA criteria [24]: HbA1C ≥6.5% or FPG ≥126 mg/dL (7.0 mmol/L) or 2-h PG ≥200 mg/dL (11.1 mmol/L) during an OGTT
	WHO criteria [19]:
	Fasting plasma glucose values of ≥ 7.0 mmol/L (126 mg/dl) OR
	2-h post-load plasma glucose ≥ 11.1 mmol/L (200 mg/dl) OR
	HbA1c ≥ 6.5% (48 mmol/mol) OR
	Random blood glucose ≥ 11.1 mmol/L (200 mg/ dl) in the presence of signs and symptoms.
	Need for diabetes medication
Metabolic syndrome	1-NCEP ATP III criteria [25]: The presence of three or more of the following risk determinants:
	Increased waist circumference (>102 cm [>40 in] for men, >88 cm [>35 in] for women);
	Elevated triglycerides (≥150 mg/dl);
	Low HDL cholesterol (<40 mg/dl in men, <50 mg/dl in women);
	Hypertension (≥130/≥85 mmHg); and
	Impaired fasting glucose (≥110 mg/dl)
	2-WHO criteria [22]: Glucose intolerance, DM2 or insulin-resistance in addition to at least two of the following:
	BMI > 30 and HWR > 0.9 (M) and > 0.85 (F)
	Serum TG ≥ 150mg/dl
	Serum HDL < 35mg/dl (M), <39mg/dl (F)
	Blood pressure ≥ 140/90 or on hypertension treatment
	Other risk factors: microalbuminuria ≥20mcg/min
	3-IDF [21]: DM/ Glucose intolerance and two or more criteria
	Fasting glucose of 100-125mg/dl Or DM 2
	WC ≥ 94cm (M), 80cm (F)
	TG ≥150mg/dl
	HDL <40mg/dl or <50mg/dl
	On treatment for SAH/ BP ≥130/85mmHG
	4-European Group for Study of Insulin Resistance definition [26]: Elevated plasma insulin (>75th percentile) plus two other factors from among the following:
	Abdominal obesity: waist circumference (WC) ≥94 cm in men and ≥80 cm in women
	Hypertension: ≥140/90 mm of Hg or on antihypertensive treatment
	Elevated triglycerides (≥150 mg/dl) and/or reduced HDL-C (<39 mg/dl for both men and women)
	Elevated plasma glucose: impaired fasting glucose (IFG) or IGT, but no diabetes
Insulin resistance	Homeostatic model for Insulin resistance (HOMA-IR) [23]

ADA- American Diabetes Association, HbA1C- Glycated Hemoglobin, PG- Plasma Glucose, OGTT- Oral Glucose Tolerance test, WHO- World Health Organization, NCEP ATP III- National Cholesterol Education Program Adult Treatment Panel III, HDL- High Density Lipoproteins, DM2- Diabetes Mellitus type II, BMI- Body Mass Index, TG- triglycerides, IDF-International Diabetes Federation, WC- Waist Circumference, SAH- Systemic Arterial Hypertension, BP- Blood Pressure, IFG- Impaired Fasting Glucose, IGT- Impaired Glucose Tolerance, HOMA-IR- Homeostatic Model for Insulin Resistance.