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The metabolic syndrome is a high-risk state for diabetes and cardiovascular disease. Little is known about its prevalence and prevention in those with impaired glucose tolerance.

To determine the prevalence of the metabolic syndrome at baseline in the Diabetes Prevention Program and the effect of intensive lifestyle intervention and metformin therapy on the syndrome's incidence and resolution.

Randomized, controlled clinical trial.

Research and community-based centers.

Participants had impaired glucose tolerance (World Health Organization criteria plus fasting plasma glucose level ≥5.3 mmol/L [≥95 mg/dL]) and were followed for a mean of 3.2 years after random assignment to intensive lifestyle intervention, metformin …