Muñoz Rossi Felipe A, Aristizábal Edison A, Saleh Kassen, Sánchez Donovan A, Quinapanta Castro Néstor Israel, Coronel Jonathan, Villota Lina A, Gonzalez Juan D, Ibarra David A, Ricardo Ossio Gina Paola
Methodology of Health Sciences Research, International University of La Rioja, Bogotá, COL.
Internal Medicine, National University of Colombia, Bogotá, COL.
Cureus. 2025 May 8;17(5):e83738. doi: 10.7759/cureus.83738. eCollection 2025 May.
Pediatric obesity is a public health problem with long-term repercussions, in which there is limited effectiveness of interventions such as lifestyle changes. This study evaluated the efficacy and safety of liraglutide in overweight/obese children and adolescents (six to 18 years) using a systematic review and meta-analysis of randomized clinical trials (RCTs). Databases such as PubMed, Web of Science, and ClinicalTrials.gov were searched up to February 2025, and the analysis included four RCTs (n=378). Liraglutide significantly reduced BMI Z-score (standardized mean difference or SMD: -1.03; 95% CI: -1.24 to -0.81; I²=0%) and showed modest improvements in HbA1c (SMD: -1.14; 95% CI: -2.10 to -0.17; I²=92%), though with high metabolic heterogeneity. There was a tendency toward increased hypoglycemia (relative risk or RR: 1.55; 95% CI: 1.00-2.40), but there was no significant difference in the overall adverse effects (RR: 1.06; 95% CI: 0.97-1.15). The results support the use of liraglutide to reduce BMI in this population, but the current evidence is limited by the small number of studies, methodological biases, and variability in metabolic outcomes. More robust RCTs and studies with prolonged follow-up are needed to consolidate liraglutide's role in the management of pediatric obesity.
儿童肥胖是一个具有长期影响的公共卫生问题，在这个问题上，诸如改变生活方式等干预措施的效果有限。本研究通过对随机临床试验（RCT）进行系统评价和荟萃分析，评估了利拉鲁肽在超重/肥胖儿童及青少年（6至18岁）中的疗效和安全性。检索了截至2025年2月的PubMed、科学网和ClinicalTrials.gov等数据库，分析纳入了四项RCT（n = 378）。利拉鲁肽显著降低了体重指数Z评分（标准化均数差或SMD：-1.03；95%置信区间：-1.24至-0.81；I² = 0%），并且糖化血红蛋白有适度改善（SMD：-1.14；95%置信区间：-2.10至-0.17；I² = 92%），尽管存在较高的代谢异质性。低血糖有增加的趋势（相对危险度或RR：1.55；95%置信区间：1.00 - 2.40），但总体不良反应无显著差异（RR：1.06；95%置信区间：0.97 - 1.15）。结果支持使用利拉鲁肽来降低该人群的体重指数，但目前的证据受到研究数量少、方法学偏倚以及代谢结果变异性的限制。需要更有力的RCT和长期随访研究来巩固利拉鲁肽在儿童肥胖管理中的作用。
