Abstract：
BACKGROUND: Despite the growing literature, the effectiveness of liraglutide in weight management among individuals with prediabetes and in preventing the disease remains controversial. This study aims to critically evaluate the extent of liraglutide\'s impact on weight management in this population and assess the heterogeneity among extant studies.
METHODS: A systematic literature search was conducted across MEDLINE, Embase, ClinicalTrials.gov, and the reference list of retrieved studies to identify eligible English language randomized controlled trials evaluating liraglutide\'s effect on weight in individuals with pre-diabetes. Non-randomized studies, studies not reporting relevant outcomes, and those conducted on patients with type 2 diabetes were excluded from this review. Outcomes included a change from baseline in absolute body weight in kg, body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), and low-density lipoprotein cholesterol levels. Additional safety outcomes were also reported. Data were analyzed using R statistical software version 4.3.1. A fixed-effect model was used when pooling crude numbers for study outcomes. Moreover, a sensitivity analysis using random-effect model was performed and heterogeneity was assessed using I2 statistics.
RESULTS: Five eligible studies were included, with a total of 1604 subjects in the liraglutide arm and 859 subjects in the control arm. Participants exposed to liraglutide showed a decrease in body weight (mean difference [MD] = -4.95 kg; 95% CI -5.16, -4.73; I2 = 93%), BMI (MD = -2.06 kg/m2; 95%CI -2.22, -1.89; I2 = 97%), waist circumference (MD = -4.61 cm; 95% CI -4.79, -4.43; I2 = 82%), HbA1c (MD = -0.33%; 95%CI -0.34, -0.31; I2 = 100%), and low-density lipoprotein cholesterol levels (MD = -0.36 mmol/L; 95% CI -0.39, -0.33; I2 = 99%). The overall effect size remained similar when using a random-effects model for all outcomes. In addition, the rate of adverse events was higher with liraglutide when compared to the control; however, the dropout rates were relatively lower in the former arm.
CONCLUSIONS: While our meta-analysis suggests that liraglutide can reduce body weight, BMI, waist circumference, and HbA1c levels in individuals with pre-diabetes, the findings should be interpreted cautiously due to limitations such as the small number of trials and their short duration, and variability in dosages. Further randomized controlled trials examining long-term outcomes are essential to validate these findings and address the high heterogeneity among the studies included in this analysis.
METHODS: A systematic literature search was conducted across MEDLINE, Embase, ClinicalTrials.gov, and the reference list of retrieved studies to identify eligible English language randomized controlled trials evaluating liraglutide\'s effect on weight in individuals with pre-diabetes. Non-randomized studies, studies not reporting relevant outcomes, and those conducted on patients with type 2 diabetes were excluded from this review. Outcomes included a change from baseline in absolute body weight in kg, body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), and low-density lipoprotein cholesterol levels. Additional safety outcomes were also reported. Data were analyzed using R statistical software version 4.3.1. A fixed-effect model was used when pooling crude numbers for study outcomes. Moreover, a sensitivity analysis using random-effect model was performed and heterogeneity was assessed using I2 statistics.
RESULTS: Five eligible studies were included, with a total of 1604 subjects in the liraglutide arm and 859 subjects in the control arm. Participants exposed to liraglutide showed a decrease in body weight (mean difference [MD] = -4.95 kg; 95% CI -5.16, -4.73; I2 = 93%), BMI (MD = -2.06 kg/m2; 95%CI -2.22, -1.89; I2 = 97%), waist circumference (MD = -4.61 cm; 95% CI -4.79, -4.43; I2 = 82%), HbA1c (MD = -0.33%; 95%CI -0.34, -0.31; I2 = 100%), and low-density lipoprotein cholesterol levels (MD = -0.36 mmol/L; 95% CI -0.39, -0.33; I2 = 99%). The overall effect size remained similar when using a random-effects model for all outcomes. In addition, the rate of adverse events was higher with liraglutide when compared to the control; however, the dropout rates were relatively lower in the former arm.
CONCLUSIONS: While our meta-analysis suggests that liraglutide can reduce body weight, BMI, waist circumference, and HbA1c levels in individuals with pre-diabetes, the findings should be interpreted cautiously due to limitations such as the small number of trials and their short duration, and variability in dosages. Further randomized controlled trials examining long-term outcomes are essential to validate these findings and address the high heterogeneity among the studies included in this analysis.
摘要：
背景：尽管文献越来越多，利拉鲁肽在糖尿病前期患者体重管理和预防疾病方面的有效性仍存在争议.本研究旨在严格评估利拉鲁肽对该人群体重管理的影响程度，并评估现有研究之间的异质性。
方法：在MEDLINE进行了系统的文献检索，Embase,ClinicalTrials.gov,和检索到的研究的参考列表，以确定合格的英语随机对照试验（RCT），评估利拉鲁肽对糖尿病前期个体体重的影响。非随机研究，未报告相关结果的研究，对2型糖尿病患者进行的研究被排除在本综述之外.结果包括绝对体重从基线的变化，以千克为单位，体重指数（BMI），腰围,糖化血红蛋白（HbA1c），和低密度脂蛋白胆固醇（LDL-C）水平。还报告了其他安全性结果。使用R统计软件版本4.3.1分析数据。当汇集粗数用于研究结果时，使用固定效应模型。此外，使用随机效应模型进行了敏感性分析，异质性使用I2统计量进行评估。
结果：纳入了5项符合条件的研究，利拉鲁肽组共有1604名受试者，对照组共有859名受试者。暴露于利拉鲁肽的参与者显示体重下降（MD=-4.95kg;95CI-5.16，-4.73;I2=93％），BMI（MD=-2.06kg/m2；95CI-2.22，-1.89；I2=97％），腰围(MD=-4.61厘米;95CI-4.79,-4.43;I2=82%),HbA1c（MD=-0.33%；95CI-0.34，-0.31；I2=100%），和LDL-C水平（MD=-0.36mmol/L；95CI-0.39，-0.33；I2=99%）。对所有结果使用随机效应模型时，总体效应大小保持相似。此外,与对照组相比，利拉鲁肽的不良事件发生率更高；然而，前者的辍学率相对较低。
结论：虽然我们的荟萃分析表明利拉鲁肽可以减轻体重，BMI,腰围,糖尿病前期个体的HbA1c水平，由于试验数量少等限制，应谨慎解释研究结果，这项研究持续时间短，和剂量的可变性。进一步研究长期结果的随机对照试验对于验证这些发现和解决本分析中包含的研究之间的高度异质性至关重要。
方法：在MEDLINE进行了系统的文献检索，Embase,ClinicalTrials.gov,和检索到的研究的参考列表，以确定合格的英语随机对照试验（RCT），评估利拉鲁肽对糖尿病前期个体体重的影响。非随机研究，未报告相关结果的研究，对2型糖尿病患者进行的研究被排除在本综述之外.结果包括绝对体重从基线的变化，以千克为单位，体重指数（BMI），腰围,糖化血红蛋白（HbA1c），和低密度脂蛋白胆固醇（LDL-C）水平。还报告了其他安全性结果。使用R统计软件版本4.3.1分析数据。当汇集粗数用于研究结果时，使用固定效应模型。此外，使用随机效应模型进行了敏感性分析，异质性使用I2统计量进行评估。
结果：纳入了5项符合条件的研究，利拉鲁肽组共有1604名受试者，对照组共有859名受试者。暴露于利拉鲁肽的参与者显示体重下降（MD=-4.95kg;95CI-5.16，-4.73;I2=93％），BMI（MD=-2.06kg/m2；95CI-2.22，-1.89；I2=97％），腰围(MD=-4.61厘米;95CI-4.79,-4.43;I2=82%),HbA1c（MD=-0.33%；95CI-0.34，-0.31；I2=100%），和LDL-C水平（MD=-0.36mmol/L；95CI-0.39，-0.33；I2=99%）。对所有结果使用随机效应模型时，总体效应大小保持相似。此外,与对照组相比，利拉鲁肽的不良事件发生率更高；然而，前者的辍学率相对较低。
结论：虽然我们的荟萃分析表明利拉鲁肽可以减轻体重，BMI,腰围,糖尿病前期个体的HbA1c水平，由于试验数量少等限制，应谨慎解释研究结果，这项研究持续时间短，和剂量的可变性。进一步研究长期结果的随机对照试验对于验证这些发现和解决本分析中包含的研究之间的高度异质性至关重要。
