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. 2023 Feb 25;22:41. doi: 10.1186/s12933-023-01765-z

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© The Author(s) 2023

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Observed MetS-Z before and after Low-calorie Diet and at Week 52 by Randomization Group. Observed MetS-Z of individual per-protocol participants (black dots) by randomization group at the three visits, before the low-calorie diet (week -8), after the low-calorie diet (week 0), and end of the trial (week 52), presented as box plots. Tops of the boxes indicate the upper quartile; bottom of the box is the lower quartile; white diamonds observed mean; black horizontal line medians; whiskers ± 1.5 times the interquartile range or highest or smallest observation. Box plots overlay MetS-Z quartiles associated with the risk of future diabetes [12] and coronary heart disease [13] compared to the first quartile and adjusted for individual MetS factors. For diabetes, unadjusted risks are also shown in parentheses. MetS-Z metabolic syndrome severity z-score. T2DM type 2 diabetes, CHD coronary heart disease