Weight Loss and Serum Lipids in Overweight and Obese Adults: A Systematic Review and Meta-Analysis
| Autor: | Muayad A Alzuabi, Tarek Nayfeh, Zhen Wang, Tamim Rajjo, Aravind R. Kuchkuntla, Mohammad Hassan Murad, Larry J. Prokop, Bashar Hasan, Connie B. Newman |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Clinical Biochemistry Bariatric Surgery Blood lipids 030204 cardiovascular system & hematology Overweight Biochemistry Gastroenterology law.invention Diet Carbohydrate-Restricted 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Endocrinology Pharmacotherapy Randomized controlled trial Weight loss law Internal medicine Weight Loss Humans Medicine Obesity 030212 general & internal medicine Diet Fat-Restricted Triglyceride business.industry Biochemistry (medical) Middle Aged medicine.disease Lipids Exercise Therapy chemistry Female lipids (amino acids peptides and proteins) medicine.symptom business Body mass index |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 105:3695-3703 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Background Excess adipose tissue is associated with an abnormal lipid profile that may improve with weight reduction. In this meta-analysis, we aimed to estimate the magnitude of change in lipid parameters associated with weight loss in adults who are overweight or obese. Methods We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus from 2013 to September, 2018. We included randomized controlled trials (RCTs) that evaluated interventions to treat adult obesity (lifestyle, pharmacologic and surgical) with follow-up of 6 months or more. Results We included 73 RCTs with moderate-to-low risk of bias, enrolling 32 496 patients (mean age, 48.1 years; weight, 101.6 kg; and body mass index [BMI], 36.3 kg/m2). Lifestyle interventions (diet, exercise, or both), pharmacotherapy, and bariatric surgery were associated with reduced triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) concentrations and increased high-density lipoprotein cholesterol (HDL-C) at 6 and 12 months. The following data are for changes in lipid parameters after 12 months of the intervention with 95% CI. Following lifestyle interventions, per 1 kg of weight lost, TGs were reduced by –4.0 mg/dL (95% CI, –5.24 to –2.77 mg/dL), LDL-C was reduced by –1.28 mg/dL (95% CI, –2.19 to –0.37 mg/dL), and HDL-C increased by 0.46 mg/dL (95% CI, 0.20 to 0.71 mg/dL). Following pharmacologic interventions, per 1 kg of weight lost, TGs were reduced by –1.25 mg/dL (95% CI, –2.94 to 0.43 mg/dL), LDL-C was reduced by –1.67 mg/dL (95% CI, –2.28 to –1.06 mg/dL), and HDL-C increased by 0.37 mg/dL (95% CI, 0.23 to 0.52 mg/dL). Following bariatric surgery, per 1 kg of weight lost, TGs were reduced by –2.47 mg/dL (95% CI, –3.14 to –1.80 mg/dL), LDL-C was reduced by –0.33 mg/dL (95% CI, –0.77 to 0.10 mg/dL), and HDL-C increased by 0.42 mg/dL (95% CI, 0.37 to 0.47 mg/dL). Low-carbohydrate diets resulted in reductions in TGs and increases in HDL-C, whereas low-fat diets resulted in reductions in TGs and LDL-C and increases in HDL-C. Results were consistent across malabsorptive and restrictive surgery. Conclusions Weight loss in adults is associated with statistically significant changes in serum lipids. The reported magnitude of improvement can help in setting expectations, inform shared decision making, and facilitate counseling. |
| Databáze: | OpenAIRE |
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