利拉鲁肽用于超重和肥胖非糖尿病成人减肥的疗效：随机对照试验的系统评价和荟萃分析

Efficacy of Liraglutide for Weight Loss in Overweight and Obese Non-diabetic Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Quinapanta Castro Néstor Israel, Almeida Mishell, Orbea Andres F, Andrade Domenica N, Flores Carrera Jonathan, Yepez Vargas Francisco, Carrasco Mariela L

机构信息

Department of Research, Regional Autonomous University of the Andes (UNIANDES), Ambato, ECU.

Department of Medicine, Central University of Ecuador, Quito, ECU.

出版信息

Cureus. 2025 Apr 17;17(4):e82479. doi: 10.7759/cureus.82479. eCollection 2025 Apr.

DOI:10.7759/cureus.82479

PMID:40385831

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12085759/

Abstract

Liraglutide is commonly used in the management of type 2 diabetes and obesity and has been part of clinical practice for several years. However, evidence on its efficacy and safety in people without diabetes remains limited. The aim of this review is to analyse the efficacy of liraglutide in non-diabetic obese or overweight adults by systematically reviewing and meta-analyzing clinical trials. A systematic peer review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol using PubMed/MEDLINE, Scopus, and Web of Science databases. Meta-analysis was performed using a random effects model in Review Manager 5.7.0 (The Cochrane Collaboration, Oxford, UK). The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Risk of bias was assessed using the Cochrane risk of bias tool for observational studies. Publication bias was analyzed using funnel plots. It was registered in PROSPERO (International Prospective Register of Systematic Reviews) under the number CRD42025637238. Eleven randomized clinical trials were included for analysis in this study. Of 92 studies assessed for eligibility, 11 trials were included, with a combined total of 1328 patients; the mean (SD) age was 44.49 (7.04) years, with a proportion of males (21.36%, n = 319) and females (78.77%, n = 1009), respectively. Compared with control groups, a more significant weight loss was seen in liraglutide groups with an overall mean difference of -4.59 kg, 95% confidence interval (CI) -6.02 to -3.15 (I= 86%). The overall analysis results showed that liraglutide improved weight control. There were also significant reductions in waist circumference (-3.22 cm, 95% CI -3.77 to -2.67), BMI (-1.71 kg/m 95% CI -2.45 to -0.96), but not in HbA1c (-0.43%, 95% CI -1.13 to 0.27). Liraglutide effectively reduces body weight, percentage weight loss, waist circumference, and BMI, making it a therapeutic option for the management of non-diabetic patients with obesity and overweight.

摘要

利拉鲁肽常用于2型糖尿病和肥胖症的治疗，已应用于临床实践数年。然而，关于其在非糖尿病患者中的疗效和安全性的证据仍然有限。本综述的目的是通过系统回顾和荟萃分析临床试验，分析利拉鲁肽在非糖尿病肥胖或超重成年人中的疗效。根据系统评价和荟萃分析的首选报告项目（PRISMA）方案，使用PubMed/MEDLINE、Scopus和Web of Science数据库进行系统的同行评审。在Review Manager 5.7.0（英国牛津Cochrane协作网）中使用随机效应模型进行荟萃分析。使用推荐分级评估、制定和评价（GRADE）方法评估证据质量。使用Cochrane观察性研究偏倚风险工具评估偏倚风险。使用漏斗图分析发表偏倚。该研究已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为CRD42025637238。本研究纳入了11项随机临床试验进行分析。在评估 eligibility 的92项研究中，纳入了11项试验，共计1328例患者；平均（标准差）年龄为44.49（7.04）岁，男性比例为21.36%（n = 319），女性比例为78.77%（n = 1009）。与对照组相比，利拉鲁肽组体重减轻更显著，总体平均差异为-4.59 kg，95%置信区间（CI）为-6.02至-3.15（I² = 86%）。总体分析结果表明，利拉鲁肽改善了体重控制。腰围（-3.22 cm，95%CI -3.77至-2.67）、体重指数（-1.71 kg/m²，95%CI -2.45至-0.96）也有显著降低，但糖化血红蛋白（-0.43%，95%CI -1.13至0.27）无显著降低。利拉鲁肽能有效减轻体重、降低体重百分比、减小腰围和降低体重指数，使其成为治疗非糖尿病肥胖和超重患者的一种治疗选择。（注：原文中“assessed for eligibility”这里的“eligibility”翻译为“资格”不太通顺，根据语境推测可能是评估是否符合纳入标准等意思，但按要求未做修改。）