Abstract

Background: Metabolic syndrome (MetS) represents a global public health challenge characterized by central obesity, insulin resistance, dyslipidemia, and hypertension. Ayurveda describes a group of disorders arising from over-nutrition and sedentary lifestyle under Santarpanottha Vyadhi. Classical descriptions of Medoroga, Prameha, Sthaulya, and Hridroga demonstrate striking conceptual parallels with MetS. Objective: To critically reinterpret Santarpanottha Vyadhi in the context of metabolic syndrome by synthesizing classical Ayurvedic literature with contemporary biomedical evidence. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Databases searched included PubMed, Scopus, Web of Science, Google Scholar, and AYUSH Research Portal up to December 2025. Classical Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, and commentaries) were reviewed to extract onceptual frameworks. Eligible experimental, clinical, and observational studies addressing metabolic disorders from Ayurvedic or integrative perspectives were included. Results: Out of 78 identified records, 52 studies met inclusion criteria. Classical texts describe Santarpana, Agnimandya, Medodushti, Ama formation, and Srotorodha as core pathological mechanisms—closely aligning with insulin resistance, chronic low-grade inflammation, adipokine dysregulation, and endothelial dysfunction described in MetS. Clinical studies indicate that Ayurvedic interventions targeting Langhana, Rukshana, Shodhana, and Medohara strategies improve metabolic parameters. Conclusion: Santarpanottha Vyadhi offers a comprehensive, systems-based explanatory model for metabolic syndrome. Integrating Ayurvedic pathophysiology with modern metabolic science can enhance preventive and therapeutic strategies.