Aim To explore the effect of peroxisome proliferator activated receptors-α/γ(PPAR-α/γ) agonist intervention alone or in combination on serum concentration of high sensitive C-reactive protein(hs-CRP) and matrix metalloproteinase-9(MMP-9) in patients with metabolic syndrome. Methods 256 patients with metabolic syndrom were randomly assigned into basic treatment group,fenofibrate group,pioglitazone group,and fenofibrate+pioglitazone group.All patients received lifestyle interventions and medications to control blood pressure.Additionally,patients in the B group received placebo.Patients in the fenofibrate group received fenofibrate 0.2 g once a day at night.Patients in the pioglitazone group received pioglitazone 15 mg once a day.Patients in the fenofibrate+pioglitazone group received both fenofibrate and pioglitazone as described above.The intervention lasted for 24 weeks.All patients' serum concentration of hs-CRP and MMP-9 were checked pre and post intervention. Results Patients' serum concentration of hs-CRP pre and post intervention in each group were 6.32±1.65 mg/L and 3.52±1.98 mg/L in the fenofibrate group,5.85±1.59 mg/L and 3.33±1.16 mg/L in the pioglitazone group,and 6.49±1.34 mg/L and 2.47±0.91 mg/L in the fenofibrate +pioglitazone group respectively.Patients' serum concentration of MMP-9 pre and post intervention in each group were 179.3±54.9 μg/L and 144.9±30.8 μg/L in the fenofibrate group,188.7±62.4 μg/L and 146.9±27.8 μg/L in the pioglitazone group,and 177.5±58.7 μg/L and 128.8±34.8 μg/L in the fenofibrate+pioglitazone group respectively.Conclusions Fenofibrate or pioglitazone intervention alone can reduce serum concentration of hs-CRP and MMP-9 in patients with metabolic syndrome.A combined use of fenofibrate and pioglitazone was more effective than single intervention with fenofibrate or pioglitazone.