Faghfouri Amir Hossein, Musazadeh Vali, Mokari-Yamchi Amin, Faramarzi Fatemeh, Pam Pedram, Shekari Shima, Mahmoudzadeh MohammadHadi, Gheibi Shahsanam
Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.
Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Obes Rev. 2025 Oct;26(10):e13946. doi: 10.1111/obr.13946. Epub 2025 May 28.
Obesity has become a growing global health concern among young people. This meta-analysis seeks to systematically assess the efficacy and safety of pharmaceutical interventions in improving body weight, body mass index (BMI), waist circumference (WC), diastolic blood pressure (DBP), fasting blood glucose (FBG), and lipid profiles, planned prior to data collection.
We conducted a comprehensive literature search on PubMed, Scopus, Embase, Web of Science, and the Cochrane Library, covering studies published up to September 2024. Randomized clinical trials (RCTs) were included if they reported efficacy of weight-loss medications in youth populations aged 2-20 years. Direct and indirect evidence were synthesized using a frequentist framework.
Pooled analysis on 30 RCTs showed that high dose phentermine/topiramate was more effective in reducing weight (MD: -15.8 kg; 95%CI: -19.17 to -12.43), BMI (MD = -5.35 kg/m2; 95% CI: -8.03, -2.67), WC (MD = -7.69 cm; 95% CI: -10.19, -5.18), and BMI percentile (MD: -20.25; 95%CI: -24.82 to 95% CI: -20.38 to -1.62) compared to placebo. Orlistat (MD = -1.81 mmHg; 95% CI: -2.94, -0.68), metformin (MD: -0.14 unit; 95%CI: -0.23 to -0.04), liraglutide (MD: -11.00 mg/dL; 95% CI: -20.38 to -1.62) were more effective in improving DBP, BMI-z score, and FBG, respectively. Lipid profile and SBP were not affected by studied drugs.
High- and moderate-dose phentermine/topiramate was more effective than a placebo in reducing anthropometric measures in youth living with overweight and obesity. Liraglutide and metformin result in a significant reduction in FBG levels compared to placebo.
肥胖已成为全球青少年日益关注的健康问题。本荟萃分析旨在在数据收集之前，系统评估药物干预在改善体重、体重指数（BMI）、腰围（WC）、舒张压（DBP）、空腹血糖（FBG）和血脂谱方面的疗效和安全性。
我们在PubMed、Scopus、Embase、Web of Science和Cochrane图书馆进行了全面的文献检索，涵盖截至2024年9月发表的研究。纳入的随机临床试验（RCT）需报告减肥药物在2至20岁青少年人群中的疗效。使用频率论框架综合直接和间接证据。
对30项RCT的汇总分析表明，与安慰剂相比，高剂量的苯丁胺/托吡酯在减轻体重（平均差：-15.8千克；95%置信区间：-19.17至-12.43）、BMI（平均差=-5.35千克/平方米；95%置信区间：-8.03，-2.67）、WC（平均差=-7.69厘米；95%置信区间：-10.19，-5.18）和BMI百分位数（平均差：-20.25；95%置信区间：-24.82至95%置信区间：-20.38至-1.62）方面更有效。奥利司他（平均差=-1.81毫米汞柱；95%置信区间：-2.94，-0.68）、二甲双胍（平均差：-0.14单位；95%置信区间：-0.23至-0.04）、利拉鲁肽（平均差：-11.00毫克/分升；95%置信区间：-20.38至-1.62）分别在改善DBP、BMI-z评分和FBG方面更有效。血脂谱和收缩压不受所研究药物的影响。
高剂量和中等剂量的苯丁胺/托吡酯在降低超重和肥胖青少年的人体测量指标方面比安慰剂更有效。与安慰剂相比，利拉鲁肽和二甲双胍可显著降低FBG水平。
