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Effects of metformin on blood lipid profiles in nondiabetic adults: a meta-analysis of randomized controlled trials

Endocrine volume 67, pages 305–317 (2020)Cite this article

Abstract

Purpose

To evaluate the effects of metformin on serum lipid profiles in nondiabetic adults through a comprehensive meta-analysis.

Methods

In the present meta-analysis, randomized and controlled trials were collected by searching PubMed, Embase, and Cochrane Libraries from inception to April 2019. Compared with placebos, the effects of metformin treatment on lipid profiles in nondiabetic adults were evaluated.

Results

Forty-seven studies from 45 articles including 5731 participants were enrolled. Pooled results showed that metformin had significant effects on total cholesterol (mean change −6.57 mg/dl; 95% CI −9.66, −3.47; P = 0.000) and LDL-c (mean change −4.69 mg/dl; 95% CI −7.38, −2.00; P = 0.001), but insignificant effects on HDL-c (mean change −4.33 mg/dl; 95% CI −9.62, 0.96; P = 0.109) and triglyceride (mean change −0.85 mg/dl; 95% CI −0.36, 2.06; P = 0.169). Significant heterogeneities were found for all lipid profiles (HDL-c = 85.5%; LDL-c = 59.9%; total cholesterol = 75.3% and triglyceride = 67.1%). Different from the pooled data, in a subgroup analysis, the effect of metformin on triglyceride in patients with polycystic ovarian syndrome (PCOS) was significant with a mean reduction of 8.15 mg/dl. In addition, sensitivity analysis showed that the pooled effects of metformin on serum lipid profiles were stable. Publication bias derived from funnel plots or Begg’s tests (P = 0.933, 0.860, 0.904, and 0.567 for HDL-c, LDL-c, total cholesterol, and triglyceride, respectively) was not significant.

Conclusion

This meta-analysis revealed that metformin could reduce total cholesterol and LDL-c in nondiabetic adults. In addition, metformin might exert a triglyceride-lowering effect in nondiabetics with PCOS status.

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Acknowledgements

This work was supported by grants from the National Natural Science Foundation of China [nos. 81870336 and 81670426 to D.P.].

Authors’ contributions

S.W. conceived the study and participated in its design. S.W. and Y.L. conducted the systematic literature review. S.W. and X.S. performed data analyses. S.W. and Z.Z. drafted the manuscript. If there would be an inconformity, corresponding author would make a final decision. All authors have read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China

    Shuwei Weng, Yonghong Luo, Ziyu Zhang, Xin Su & Daoquan Peng

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  1. Shuwei Weng
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  2. Yonghong Luo
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  3. Ziyu Zhang
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Correspondence to Daoquan Peng.

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This article does not contain any studies with human participants or animals performed by any of the authors. We admit that this meta-analysis is complied with ethical standards. Since this is a meta-analysis based on the published articles, therefore the ethical approval is not applicable.

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Weng, S., Luo, Y., Zhang, Z. et al. Effects of metformin on blood lipid profiles in nondiabetic adults: a meta-analysis of randomized controlled trials. Endocrine 67, 305–317 (2020). https://doi.org/10.1007/s12020-020-02190-y

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  • DOI: https://doi.org/10.1007/s12020-020-02190-y

Keywords

  • Metformin
  • Meta-analysis
  • Nondiabetic
  • Serum lipid