1. Your Nomination - Please briefly describe in your own words the question about a health care test or treatment that interests or concerns you:

Global risk reduction guideline for cardiometabolic protection in metabolic syndrome

2. Why do you think your question is important? (you may select more than one category if appropriate)

 My question relates to a very common disease or problem
 People with this disease or problem have considerable health or financial hardships
 There is uncertainty about how well the test, treatment, or intervention works
 There is significant potential for side effects/harms using this test, treatment, or intervention
 Funding of this test, treatment, or intervention is uncertain or variable
 There is unequal access or application of this health care intervention across providers
 There is potential for cost savings from better information on this subject
 This is a new technology/development
 There is new evidence of clinical and/or cost effectiveness for this test, treatment, or intervention
 Other

3. What illness or health condition is related to your question? (You can also specify a particular health-promoting activity, such as breast-feeding)

Metabolic syndrome is a major health problem worldwide and touches multiple risks.Guidelines for diagnosis of the syndrome are already issued and clinicians are eager to see a standard treatment guidline for cardioprotection.furthermore,inconsistent approaches are emerging for whom to protect,so we need a panel of experts to define the best strategy to treat based on evidences and mega trials, randomized clinical controlled trials..etc

4. What group(s) or patients does your question apply to?

people at risk of developing coronar heart disease:Obese, dyslipidemics,patients with IGT, hypertensives

5. What is the specific purpose of the health care test or treatment you have a question about? (mark all that you think apply)

Identification of a disease or condition:
 Screening or diagnosis/identification for a particular disease, or risk assessment for a disease
 Risks or harms that can come from a disease identification tool or test
 Diagnostic tests and tools
 Diagnosis of co-occurring diseases
 Intervention (such as a drug treatment, therapy, device)
 Management of a condition or particular system of care
 Delivery of a health service
 Referral
 Risks or harms associated with treatment of a disease or condition
 Prevention or health promotion
 Specific population health concerns, such as ethnic group or gender
 Other
 Dont know

6. Does your question include a comparison of different health care approaches?

Yes
If yes, please list what you would like to see compared:
Different diagnostic criteria for metabolic syndrome led to different bases of managment and priorties are different among scientists whether to concentrate on obesity or insulin rsistance or dyslipidemia as a cornerstone in managing this sophisticated syndrome.I think there must be a unified pathophysiological mechanism linking various aspects of metabolic syndrome on a molecular level.Untill we discover this,clinician feels puzzled when trying to treat patients

7. Desired Health Improvements: If you question focuses on:

Identification of a particular disease or condition, what improvements in identification or diagnosis would you like to see?


Treatment of a particular disease or condition, what improvements in patient symptoms or problems would you like to see? tackling metabolic syndrome via targeting multiple pathophysiological mechanisms through mega trials may provide strong evidences for the best approach to follow

8. Harms: Are there risks, side effects, or harms you are concerned about? If yes, please specify what those are:

9. Based on your answers to the previous questions, what research question(s) would you like to have answered?

What is the keyplayer molecules in metabolic syndrome is it insulin resistance or obesity-related unknown molecular disturbances or does recommbinant human adiponectin have potential future positive impacts on amelioration of insulin resistance and obesity of metabolic syndrome?Can we achieve good results via treating separately every component of metabolic syndrome and how can we advocate innovative biomedical researches to target harmful molecules thought to mediate metabolic syndrome such as endothelins,cytokines, chemokins or targeting misfolding of mitochondrial proteins or suggested erratic insulin production from beta cells

10. Are there health-care focused, disease-focused, or patient-focused organizations that you see as being relevant to this issue? Who do you think we should contact as we consider your nomination?

world Health organization,American Heart Association, American Diabetes Association,Ameriacn association of Clinical endocrinololgists,NHLBI

11. Other Information About You (OPTIONAL) In order to help us understand the context of your health care question, it would be helpful to know more about you. The answers you give will not influence the progress of your suggestion. Thank you.

a. Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
Physician

b. Is there any other information about you that is relevant to your question?


c. Are you making a suggestion as an individual or on behalf of an organization?
 Individual
 Organization