Glucagon-like Peptide 1 Receptor Agonists Modestly Reduced Low-density Lipoprotein Cholesterol and Total Cholesterol Levels Independent of Weight Reduction: A Meta-analysis and Meta-regression of Placebo Controlled Randomized Controlled Trials

• Main Authors: Rivera, Frederick Berro, Chin, Marielle Nicole Cabusas, Pine, Polyn Luz S., Ruyeras, Monica Marie Jadena, Galang, Danica Janine Cabahug, Gandionco, Keshia Marice, Morales, Benna Lynn Faye D., Climaco, Zackaree Michael V., Bantayan, Nathan Ross Baoy, Magalong, John Vincent, Mangubat, Gerard Francis, Ong, Kenneth
• Format: text
• Published: Archīum Ateneo 2024
• Subjects: Dulaglutide; Glp-1RA; lipids; liraglutide; Semaglutide; Diseases; Medicine and Health Sciences; Nutritional and Metabolic Diseases
• Online Access: https://archium.ateneo.edu/asmph-pubs/290; https://doi.org/10.1080/03007995.2024.2442027
• Institution: Ateneo De Manila University

Background The effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on lipid components are unclear. We aim to quantify the lipid lowering effects of GLP1-RAs. Methods A comprehensive database search for placebo-controlled randomized controlled trials (RCTs) on GLP-1RA treatment was conducted until January 2023. Data extraction and quality assessment were performed, and outcomes were analyzed using a random-effects model to calculate weighted mean differences (MDs) in milligrams per deciliter (mg/dl) and 95% confidence intervals (CIs). The primary endpoint was the mean difference in low-density lipoprotein cholesterol (LDL-C). Secondary endpoints included total cholesterol (TC), triglycerides, high density lipoprotein-C (HLD-C), and very low-density lipoprotein-C (VLDL-C). Subgroup analyses and meta-regression accounted for covariates. Results GLP-1RAs modestly reduced LDL-C (MD −2.93, 95% CI (-5.01, −0.85), p = 0.01), consistent across treatment durations: ≤12 weeks (MD: −5.39, 95% CI (-10.36, −0.42), p = 0.03) and >12 weeks (MD: −2.39, 95% CI (-4.70, −0.007), p = 0.04). GLP-1RA reduced TC by ∼7 mg/dl. There was no significant reduction in triglycerides (MD = −7.19, 95% CI (-15.01, 0.62), p = 0.07) or VLDL-C (MD = −3.99, 95%, CI (-8.73, 0.75), p = 0.10). GLP-1RA did not increase HDL-C (MD = −0.12, 95% CI (-0.73, 0.49), p = 0.69). Weight change did not influence LDL-C (tau2 = 28.38, I2 = 99.83, R2 = 0.0, p = 0.67) or TC (tau2 = 93.6, I2 = 99.86, R2 = 0.0, p = 0.92). Conclusion GLP-1RA treatment modestly decreased LDL-C and TC but did not significantly affect triglycerides, VLDL-C, or HDL-C.