Various prospective studies have demonstrated that hs-CRP and IR independently predict future cardiovascular risk and development of T2DM, with additive prognostic information beyond that available from the Framingham risk score [5, 19, 20] Insulin resistance and inflammation (hs-CRP) are also known as two parameters tightly associated with cardiac apoptosis [19, 20]. We found that after 8 weeks of endurance training (10–22 m min-1, 10–60 min d-1 ) and resistance training (30–100 0 /0 body weight) programs 3 times per week with and without garlic extract supplementation (500 mg.kg-1 .day-1 ), hs-CRP concentration was significantly lower in ET (-42 0 /0), RT (-51 0 /0), GE (-60 0 /0) and ET + GE (-54 0 /0) groups compared to the MetS-Con group, nevertheless, the RT + GE did not have a significant effect on the hs-CRP level. The results of this study indicated that mean of the insulin resistance after 8 weeks exercise and supplementation interventions, in groups ET -75 0 /0, RT -77 0 /0, GE -73 0 /0, ET + GE -90 0 /0, RT + GE -73 0 /0 was lower compared to the MetS-Con group. Fasting glucose level in all interventions except for the combination of resistance exercise with the garlic supplementation have the relatively samepositive effect. Bax gene expression in the groups of the ET -73 0 /0, RT -74.5 0 /0, GE -78 0 /0, ET + GE -77 0 /0, RT + GE -73 0 /0 were lower compared to the MetS-Con group. And Bcl-2 gene expression in the groups of the ET + 42 0 /0, RT + 47.5 0 /0, GE + 41.5 0 /0, ET + GE + 72 0 /0, RT + GE + 69 0 /0 were higher compared to the MetS-Con group. We found that hs-CRP level in the ET and RT groups significantly decreased after 8 weeks of training. Thus, adaptation after the last of six weeks of training probably can be related to significant changes in the hs-CRP level. Davis et al. [21] and King et al.[22] confirmed the effect of intensity and duration of exercise on inflammatory markers. However, enhanced NK cell activity may confer a resistance to acute inflammation in individuals. High levels of exercise and physical fitness are associated with improved insulin resistance, lower levels of body fat and low oxidized density lipoprotein cholesterol (LDL-C(. These factors may be non-infectious triggers for elevated hs-CRP [23]. Higher physical fitness levels is related to an anti-inflammatory effect that may be a mechanism for lowering coronary heart disease (CHD) and metabolic syndrome risks [23]. In contrast, it was demonstrated that resistance training cannot affect the hs-CRP [24]. Moreover, research findings has shown that high-intensity eccentric training, can stimulate acute phase response (APS) and hs-CRP [24]. In addition, hs-CRP level in the ET + GE group was lower compared to the RT + GE group. Furthermore, hs-CRP level in the RT + GE group was higher compared to RT group. It could probably cause higher levels of glucose in the RT + GE group. Reports have shown that high glucose levels can increase levels of key proteins (hsCRP) that has links to inflammation. Interestingly, the results showed that garlic extract supplementation improved hs-CRP level significantly. These results are almost similar to those of a study by Aalami-Harandi et al. [25] that reported supplementation of garlic for nine weeks led to decreased hs-CRP. Mechanism of probable reduction of hs-CRP via garlic can be the reduction in the production of reactive oxygen species (ROS) and reduction of the damage of cells caused by the macrophage inducing a reduction in the activation of endothelial cells for gene expression of adhesion molecules and increased endothelial nitric oxide synthase. In contrast, van Doorn et al. [26] concluded that a garlic preparation has no significant effect on inflammatory parameters and endothelial function in cardiovascular diseases (CVD). The results of this study showed that amount of glucose significantly decreased after 8 weeks ET, RT and GE supplementation. Insulin levels was lower after this period compared to MetSCon group. The possible mechanism could be the improve in insulin sensitivity following regular exercise [27, 28]. In addition, the results of this study indicated that the glucose levels in RT + GE group were higher compared to RT group. Higher glucose levels may be caused by lower total antioxidant capacity in the resistance training group. Following the course of the study, merely insulin resistance was significantly improved in group ET and RT compared to the MetS-Con. In line with our study, Ho Ha et al. [29] also reported that a 12-week training protocol positively affected insulin resistance and insulin levels. In another study, 4-month walking did not have any impact on insulin resistance of diabetic patients. Thus, a long-term training may be necessary to determine whether aerobic exercises are more advantageous for improvement insulin resistance level in an experienced population [30]. Sun QY et. al. [31] reported 8 weeks of exercise intervention significantly reduced glucose. Exercise training increases the activities of phosphoinositide 3-kinase (PI3K) / Protein kinase B (PKB)/ endothelial nitric oxide synthase (eNOS) as well as the increase in phosphorylation of PI3K/Akt/eNOS in response to insulin. Interestingly, exercise training improves vasodilation in response to acetylcholine (Ach) and insulin by the same pathway of PI3K/Akt-mediated eNOS signaling cascades. Studies have indicated that expression of TNF-α and activation of p38 mitogen-activated protein kinase (p38 MAPK) markedly decreased through exercise training. In addition, the results of this study showed that endurance training with a supplement of garlic extract is more beneficial than other interventions on insulin resistance and glucose. The possible cause could be higher total antioxidant capacity and lower inflammation in endurance group taking garlic supplements. Our study showed that GE supplementation is effective in improving insulin sensitivity in rats with metabolic syndrome. Padiya R et al. [32] confirmed the effect of garlic on improving insulin sensitivity in fructose-fed rats. This probably comes from the effect of Garlic on insulin and may related to antioxidant feature of S-allyl cysteine sulfoxide in garlic. Garlic allicin can be effectively combined with compounds like cysteine and enhance serum insulin. On the other hand, garlic can act as an antidiabetic agent by increasing either the pancreatic secretion of insulin from the ß-cell [33]. Our study showed that mean of Bax and BCL2 gene expression in the groups of the ET, RT, GE, ET + GE, RT + GE compared to the MetS-Con group was lower, and there is no difference between training groups and supplementation positive effects on improvement of apoptosis index. This result was consistent with the study by the Kwak H B10 who have shown protective effects of the endurance exercise training against elevated apoptosis and lowering Bax protein expression in the aging rat heart. Moreover, Campbell K L et al [33]. have observed that exercise training induces the expression of Bax and BCL2 gene in the sedentary participants. Exercise training may increase cell-survival proteins including Mn isoform of superoxide dismutase (MnSOD), NF-kB, extracellular receptor kinase (ERK), IGF-1/Akt pathway, and heat shock proteins (HSPs) in heart [34]. Our findings also showed changes in Bax protein expression levels in response to GE supplementation. Cheng Y C et al [35]. suggested garlic oil supplementation for 8 weeks may have protective effects on cardiac apoptosis in rats with high cholesterol intake. This could be possible via the p38 MAPK signal transduction pathway that functions to stimulate the activation of nuclear factor-kappa B, caspase-3 and − 9 [33]. Ultimately, this study hypothesized whether exercise and garlic supplementation improved hsCRP and IR in line with Bax and BCL2 protein expression in rats with MetS. In accordance with the hypotheses, the present findings demonstrated that ET, RT with and without GE supplementation have beneficial effects on reducing Bax gene expression in rats with MetS. ET alone, GE alone and ET + GE affected hs-CRP level; however, the reduction was greater in GE group. In addition, ET, RT with and without GE supplementation had beneficial effects on reducing IR. Yet, the reduction was greater in ET + GE group compared to other groups. However, more extensive research is needed before recommending exercise and GE supplementation to humans with metabolic syndrome.