Zhao Yingke, Yu Branda Yee-Man, Liu Yanfei, Tong Tiejun, Liu Yue
School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Cardiovascular diseases center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Medicine (Baltimore). 2018 Dec;97(50):e13246. doi: 10.1097/MD.0000000000013246.
There is widespread obesity paradox in cardiovascular diseases, the cardiovascular influence from weight management remains controversial. Moreover, previous publications indicating that different weight reduction extent might lead to various results. Thus, it is of importance to reassess the cardiovascular benefits of weight management strategies.
This review is designed to assess the association between weight loss and cardiovascular outcomes.
Clinical trials including randomized control trials, observational studies reported a weight change before and after weight interventions including lifestyle intervention, as well as pharmacotherapies were included. Three major databases will be searched to retrieve the appropriate studies. Dual selection and abstraction of data will be conducted by 2 authors independently. The population, intervention, comparator, outcomes, study characteristics framework will be used to extract all the necessary data from included studies. The risk of bias assessment will be conducted in duplicate based on the Cochrane risk of bias guideline for randomized controlled trials (RCTs) and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement for observational studies respectively. The primary outcomes will be the cardiovascular mortality, and the secondary outcomes are all-cause mortality and new cardiovascular events. A meta-analysis will be considered if there is sufficient homogeneity among selected studies. Follow the criteria of Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the quality of the cumulative evidence will be evaluated.
The results of this systematic review could provide reliable and concrete evidence for weight loss and its cardiovascular benefits.Prospero registration number: CRD42018108582.
心血管疾病中存在广泛的肥胖悖论，体重管理对心血管的影响仍存在争议。此外，先前的出版物表明，不同的减重程度可能会导致不同的结果。因此，重新评估体重管理策略对心血管的益处具有重要意义。
本综述旨在评估体重减轻与心血管结局之间的关联。
纳入包括随机对照试验、观察性研究在内的临床试验，这些研究报告了包括生活方式干预以及药物治疗在内的体重干预前后的体重变化。将检索三个主要数据库以获取合适的研究。由两名作者独立进行数据的双重筛选和提取。将使用人群、干预措施、对照、结局、研究特征框架从纳入研究中提取所有必要数据。将分别根据Cochrane随机对照试验（RCT）偏倚风险指南和流行病学观察性研究报告强化声明（STROBE）对观察性研究进行重复的偏倚风险评估。主要结局将是心血管死亡率，次要结局是全因死亡率和新的心血管事件。如果所选研究之间存在足够的同质性，则将考虑进行荟萃分析。遵循推荐分级、评估、制定和评价（GRADE）标准，对累积证据的质量进行评估。
本系统评价的结果可为体重减轻及其心血管益处提供可靠而具体的证据。
Prospero注册号：CRD42018108582。
