Efficacy and safety of GLP-1RA on cardio-metabolic outcomes in overweight or obese Chinese adults: a systematic review and meta-analysis.
GLP-1 receptor agonists may lead to significant reductions in body weight and other cardiometabolic risk factors in overweight or obese Chinese adults, but further research is needed to confirm these findings.
Where it sits
this study against the rest of the liraglutide corpusSummary and findings
This systematic review and meta-analysis evaluated the efficacy and safety of GLP-1 receptor agonists (GLP-1RAs) in overweight or obese Chinese adults. A total of 2,204 participants were analyzed, with 1,522 receiving GLP-1RA therapy. The study reported significant reductions in various cardiometabolic parameters, including body weight and HbA1c.
Abstract
<h4>Background</h4>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated substantial weight loss and metabolic benefits in overweight and obese populations. However, their cardio-metabolic efficacy and safety profile in Chinese adults remain incompletely characterized.<h4>Methods</h4>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing GLP-1RAs or dual GLP-1/GIP receptor agonists with placebo in overweight or obese Chinese adults. Searches were performed in PubMed, Cochrane CENTRAL, and Scopus from inception to October 12, 2025. Outcomes included changes in body weight, waist circumference, HbA1c, fasting glucose, cholesterol, systolic and diastolic blood pressure, and adverse events. Effect sizes were pooled using random-effects models and reported as mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs).<h4>Results</h4>Five RCTs comprising 2,204 participants were included, of whom 1,522 received GLP-1RA therapy and 682 received placebo. GLP-1RAs significantly reduced body weight (MD: -10.06 kg; 95% CI: -15.56 to - 4.56), waist circumference (MD: -7.06 cm; 95% CI: -9.85 to - 4.26), HbA1c (MD: -0.41%; 95% CI: -0.56 to - 0.27), fasting glucose (MD: -0.48 mmol/L; 95% CI: -0.69 to - 0.27), cholesterol (MD: -7.95 mg/dL; 95% CI: -9.57 to - 6.33), systolic blood pressure (MD: -4.26 mmHg; 95% CI: -6.28 to - 2.23), and diastolic blood pressure (MD: -2.44 mmHg; 95% CI: -3.70 to - 1.18). GLP-1RAs were associated with increased risks of gastrointestinal adverse events, including nausea, diarrhea, and vomiting, but not serious adverse events.<h4>Conclusion</h4>Among overweight or obese Chinese adults, GLP-1RAs produce clinically significant improvements in body weight and multiple cardiometabolic risk factors while maintaining an acceptable safety profile. These findings support the role of GLP-1RAs as effective long-term therapeutic options for metabolic risk reduction in this population.<h4>Clinical trial registration</h4>Not applicable.<h4>Supplementary information</h4>The online version contains supplementary material available at 10.1007/s40200-026-02000-8.
Background
This paper addresses the efficacy and safety of GLP-1 receptor agonists (GLP-1RAs) in managing cardio-metabolic outcomes among overweight or obese Chinese adults. Prior research has indicated that GLP-1RAs can lead to weight loss and metabolic improvements, but specific data on their effects in this demographic were lacking. This study aims to fill that gap by systematically reviewing and analyzing relevant randomized controlled trials.
Methods
The authors conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing GLP-1RAs or dual GLP-1/GIP receptor agonists with placebo. A total of 2,204 participants were included, with 1,522 receiving GLP-1RA therapy and 682 receiving placebo. The outcomes measured included body weight, waist circumference, HbA1c, fasting glucose, cholesterol, systolic and diastolic blood pressure, and adverse events.
Results
The primary endpoint showed a mean difference (MD) of -10.06 kg (95% CI: -15.56 to -4.56) in body weight reduction among participants receiving GLP-1RAs compared to placebo. Additional significant reductions were reported for waist circumference (MD: -7.06 cm; 95% CI: -9.85 to -4.26), HbA1c (MD: -0.41%; 95% CI: -0.56 to -0.27), fasting glucose (MD: -0.48 mmol/L; 95% CI: -0.69 to -0.27), cholesterol (MD: -7.95 mg/dL; 95% CI: -9.57 to -6.33), systolic blood pressure (MD: -4.26 mmHg; 95% CI: -6.28 to -2.23), and diastolic blood pressure (MD: -2.44 mmHg; 95% CI: -3.70 to -1.18).
Interpretation
The findings suggest that GLP-1RAs can lead to statistically significant improvements in various cardiometabolic parameters in overweight or obese Chinese adults. However, while the effect sizes are statistically significant, the clinical significance, particularly for parameters like HbA1c and weight reduction, should be interpreted cautiously. The study's limitations, including the moderate sample size and potential biases, may affect the generalizability of these results.
Key findings
- MD: -10.06 kg; 95% CI: -15.56 to -4.56 for body weight reduction.
- MD: -7.06 cm; 95% CI: -9.85 to -4.26 for waist circumference reduction.
- MD: -0.41%; 95% CI: -0.56 to -0.27 for HbA1c reduction.
- MD: -0.48 mmol/L; 95% CI: -0.69 to -0.27 for fasting glucose reduction.
- MD: -7.95 mg/dL; 95% CI: -9.57 to -6.33 for cholesterol reduction.
- MD: -4.26 mmHg; 95% CI: -6.28 to -2.23 for systolic blood pressure reduction.
Limitations
- Moderate sample size of n=2,204.
- Potential publication bias in included RCTs.
- Not all outcomes may have been reported consistently across studies.
- Short follow-up duration not specified.