{
  "abstract": "Background: Metabolic syndrome (MetS) is a major contributor to cardiovascular morbidity, yet our healthcare system is underdeveloped in terms of effective lifestyle interventions. Telemedicine-based programs may offer a scalable option, but evidence on their effectiveness in MetS populations is limited.\n\nObjective: To evaluate a combined telemedicine-supported lifestyle program compared to non-randomized controls in adults with MetS and identify adherence-related factors associated with weight loss.\n\nMethods: In this prospective, non-randomized controlled intervention study (2021–2023, Hungary), 133 adults with MetS were enrolled and 111 completed a 90-day lifestyle program. All participants received an initial dietetic consultation; the intervention group additionally used smartphone-based dietary logging, remote exercise monitoring, and biweekly teleconsultations with dietitians and physiotherapists. Primary outcome was waist circumference at the standardized day-90 follow-up; secondary outcomes included body weight, body composition, exercise capacity, metabolic parameters, and adherence indicators. Outcomes were analyzed by baseline-, age-, and sex-adjusted ANCOVA with HC3-robust standard errors; the primary model included a group-by-baseline waist circumference interaction, and exploratory adherence analyses assessed linear trends across ordered weight-loss subgroups.\n\nResults: A significant group-by-baseline waist circumference interaction was observed ( p = 0.029), with a greater adjusted intervention–control difference at higher baseline waist circumference. The intervention group also showed descriptive reductions in body weight (–5.23 ± 5.16 kg), BMI, skinfold thicknesses, body fat mass, and visceral fat. HbA1c declined by 0.41 ± 0.60 percentage points ( p < 0.001), and HDL-cholesterol increased significantly, while other laboratory parameters changed modestly. After Benjamini–Hochberg adjustment within the respective outcome families, the adjusted between-group differences in abdominal circumference, HbA1c, and skeletal muscle mass remained statistically significant. Exploratory adherence analyses showed significant trends toward more frequent body-weight logging and lower relative energy intake with greater weight loss, but not for the other adherence measures.\n\nConclusions: A telemedical lifestyle program was associated with favorable short-term changes in abdominal obesity, body composition, and metabolic control in adults with MetS, although skeletal muscle mass loss was also observed. Regular self-weighing and maintaining a lower relative energy intake were associated with greater weight loss. Telemedicine-supported lifestyle management may represent a promising approach for MetS care.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Preventive Medicine, Albert Szent-Györgyi Medical School, University of Szeged",
    "Department of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged",
    "Department of Physiotherapy, Faculty of Health Sciences and Social Studies, University of Szeged",
    "Department of Medical Physics and Informatics, Albert Szent-Györgyi Medical School, University of Szeged",
    "Medical Informatics Research and Development Centre, University of Pannonia"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Judit Erzsébet Ábrahám"
    },
    {
      "affs": [
        1
      ],
      "name": "Anna Vágvölgyi"
    },
    {
      "affs": [
        2
      ],
      "name": "Éva Máthéné Köteles"
    },
    {
      "affs": [
        2
      ],
      "name": "Andrea Korom"
    },
    {
      "affs": [
        2
      ],
      "name": "Mária Barnai"
    },
    {
      "affs": [
        3
      ],
      "name": "Mónika Szűcs"
    },
    {
      "affs": [
        0
      ],
      "name": "Brigitta Szálka"
    },
    {
      "affs": [
        0
      ],
      "name": "András Király"
    },
    {
      "affs": [
        4
      ],
      "name": "István Vassányi"
    },
    {
      "affs": [
        1
      ],
      "name": "Attila Nemes"
    },
    {
      "affs": [
        1
      ],
      "name": "Tamás Várkonyi"
    },
    {
      "affs": [
        1
      ],
      "name": "Csaba Lengyel"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "István Kósa"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c9hd5td37gbj8.bib",
  "cited_by": 0,
  "doi": "10.3389/fcvm.2026.1804026",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1804026/full",
  "id": "c9hd5td37gbj8",
  "issns": [
    "2297-055X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1804026/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "3600|Mobile Health and mHealth Applications"
    ]
  ],
  "openalex": "W7223650713",
  "pdf_url": "https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2026.1804026/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-26",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/c9hd5td37gbj8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "10.3389/fcvm.2026.1804026",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1804026/full"
    },
    {
      "first_seen": "2026-10-30T13:47:29Z",
      "native_id": "4adc4dd3ef84456fb41232616a5aff29",
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      "url": "https://doi.org/10.3389/fcvm.2026.1804026"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC666-701",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Adherence-related factors associated with weight reduction: clinical outcomes of telerehabilitation in patients with metabolic syndrome",
  "title_text": "Adherence-related factors associated with weight reduction: clinical outcomes of telerehabilitation in patients with metabolic syndrome",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:47:29Z",
  "url": "https://research.draconitic.com/paper/c9hd5td37gbj8",
  "venue": "Frontiers in Cardiovascular Medicine",
  "versions": []
}