Trends in baseline blood lipid levels in randomized placebo-controlled trials of overweight or obesity from 1990 to 2024.

IF 4.6 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-09-15 DOI:10.4239/wjd.v16.i9.110639

Ya-Qi Wang, Quan-Zhou Xiao, Zhen-Ming Zhang, Yan Yang

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Abstract

Background: The global rise in overweight and obesity has reached alarming levels, substantially increasing the risk of metabolic disorders such as dyslipidemia. We outlined the evolving trends in baseline blood lipid levels among patients experiencing overweight or obesity, as observed in placebo-controlled randomized trials, to address the unmet clinical requirements.

Aim: To assess long-term trends in lipid profiles in overweight or obese populations and their association with clinical and treatment factors.

Methods: EMBASE, PubMed, Cochrane Library, and Web of Science databases were searched up to October 9, 2024. Randomized placebo-controlled trials of participants with overweight or obesity, with reports of baseline lipid levels, were included. The main outcome was a correlation between pooled baseline levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) with study year. Subgroup analysis was conducted based on characteristics of the populations and intervention types.

Results: A comprehensive meta-analysis encompassing 866 studies across nearly 60 countries and regions worldwide, involving 3300 participants, revealed significant temporal trends in baseline lipid profiles. The analysis revealed a significant decline in TG (Rs = -0.704, P < 0.001, I ² = 98.6%), TC (Rs = -0.884, P < 0.001, I ² = 99.6%), and LDL-C (Rs = -0.808, P < 0.001, I ² = 96.8%) levels. In contrast, HDL-C (Rs = 0.336, P = 0.041, I ² = 99.2%) levels exhibited a progressive increase over the study period. Subgroup analyses revealed that sex, body mass index, blood pressure, diabetes status, and type of intervention influenced the observed trends, especially with patients receiving pharmacological therapies demonstrating more pronounced improvements (TG: Rs = -0.449, P _adj = 0.011; I ² = 98.9%; TC: Rs = -0.650, P _adj = 0.001; I ² = 99.4%; HDL-C: Rs = 0.650, P _adj = 0.002; I ² = 98.6%; LDL-C: Rs = -0.417, P _adj = 0.031; I² = 98.0%).

Conclusion: Despite rising obesity rates, lipid control has improved over three decades among individuals with overweight or obesity, reflecting the positive impact of public health efforts and effective dyslipidemia treatment strategies.

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1990年至2024年超重或肥胖随机安慰剂对照试验中基线血脂水平的趋势

背景：全球超重和肥胖的增加已经达到了令人担忧的水平，大大增加了血脂异常等代谢紊乱的风险。我们概述了在安慰剂对照随机试验中观察到的超重或肥胖患者基线血脂水平的演变趋势，以解决未满足的临床要求。目的：评估超重或肥胖人群脂质谱的长期趋势及其与临床和治疗因素的关系。方法：检索截止到2024年10月9日的EMBASE、PubMed、Cochrane Library和Web of Science数据库。纳入了超重或肥胖参与者的随机安慰剂对照试验，并报告了基线脂质水平。主要结果是甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）的综合基线水平与研究年份的相关性。根据人群特征和干预类型进行亚组分析。结果：一项综合荟萃分析涵盖了全球近60个国家和地区的866项研究，涉及3300名参与者，揭示了基线脂质谱的显著时间趋势。分析显示TG （Rs = -0.704, P < 0.001, I 2 = 98.6%）、TC （Rs = -0.884, P < 0.001, I 2 = 99.6%）和LDL-C （Rs = -0.808, P < 0.001, I 2 = 96.8%）水平显著下降。相反，HDL-C （Rs = 0.336, P = 0.041, I 2 = 99.2%）水平在研究期间呈渐进式上升。亚组分析显示，性别、体重指数、血压、糖尿病状况和干预类型影响观察到的趋势，特别是接受药物治疗的患者表现出更明显的改善（TG: Rs = -0.449, P = 0.011; I 2 = 98.9%; TC: Rs = -0.650, P = 0.001; I 2 = 99.4%; HDL-C: Rs = 0.650, P = 0.002; I 2 = 98.6%; LDL-C: Rs = -0.417, P = 0.031; I²= 98.0%）。结论：尽管肥胖率上升，但30年来超重或肥胖人群的脂质控制有所改善，这反映了公共卫生努力和有效的血脂异常治疗策略的积极影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.