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Effects of Anti-Obesity Agents on Fat Distribution: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials
41 Pages Posted: 7 Dec 2023
More...Abstract
Background: Pharmacotherapy provides a therapeutic option for overweight and obese people to reduce their body weight, but little is known regarding the influence of anti-obesity agents on fat distribution. Here, we summarize the latest evidence outlining the benefits of weight-lowering drugs on fat distribution.
Methods: This systematic review and network meta-analysis included searches of PubMed, Embase, and Cochrane Library databases for RCTs of weight-lowering drugs in people between inception and May 23, 2023. The primary outcomes were visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). The secondary outcomes included changes in body weight and waist circumference. The STATA 14.0 software package was used for statistical analysis. We performed random-effect network meta-analyses using a frequentist approach.
Results: A total of 39 articles including 41 RCTs with 2741 patients were included. Following a mean treatment duration of 29.4 weeks, glucagon-like peptide 1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT-2) inhibitors were found to reduce VAT (-0.90 [-1.32 to -0.47] and -0.66 [-1.22 to -0.10]) compared to placebo, while only GLP-1 receptor agonists reduced SAT (-1.01 [-1.58 to -0.43]). Naltrexone-bupropion, GLP-1 receptor agonists, SGLT-2 inhibitors and metformin were found to reduce body weight (-5.60 [-8.64 to -2.56], -4.73 [-5.58 to -3.88], -3.20 [-4.69 to -1.72] and -1.93 [-3.01 to -0.85]). Finally, GLP-1 receptor agonists, naltrexone–bupropion, SGLT-2 inhibitors and metformin led to a reduction in waist circumference (-4.89 [-5.42 to -4.36], -3.50 [-6.41 to -0.59], -2.96 [-4.99 to -0.92] and -1.18 [-1.41 to -0.95]).
Conclusion: This analysis indicated that GLP-1 receptor agonists may have advantages over other anti-obesity agents in reducing VAT and SAT. SGLT-2 inhibitors were more helpful to reduce VAT.
Funding: This work was supported by the National High Level Hospital Clinical Research Funding (BJ-2022-195).
Declaration of Interest: The authors declare that the research was conducted without any commercial or fnancial relationships that could be construed as a potential confict of interest.
Keywords: Anti-obesity agents, Body fat distribution, Network meta-analysis
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