Effects of Ellagic Acid on Lipid Profiles, Fat Weight, and Anthropometric Parameters in Metabolic Syndrome: A Systematic Review and Meta-analysis of Animal and Human Studies

Metabolic syndrome, characterized by dyslipidemia, central obesity, hypertension, hyperglycemia, and insulin resistance, increases the risk of cardiovascular diseases and poses a global health challenge. Ellagic acid (EA), a polyphenol with antioxidant and lipid-lowering properties, shows potential as a therapeutic candidate for modulating metabolic markers. This study aimed to assess the effects of EA on lipid profiles, fat weight, and anthropometric parameters in animals and humans with abnormal metabolic markers or pre-obesity through a systematic review and meta-analysis. Literature searches were conducted using PubMed, Scopus, Embase, and Cochrane Library databases up to October 22, 2024. Data were extracted from 78 studies. A random-effects model calculated the standardized mean difference (SMD) with the 95% CI. EA significantly reduced triglyceride levels in animals (SMD = -2.93; 95% CI, -3.78 to -2.07; P < .0001) and humans (SMD = -0.58; 95% CI, -0.87 to -0.29; P = .0001) and increased high-density-lipoprotein cholesterol levels in animals (SMD = 1.24; 95% CI, 0.58 to 1.90; P = .0002) and humans (SMD = 0.72; 95% CI, 0.37 to 1.07; P < .0001). Ellagic acid also reduced fat weight in epididymal (SMD = -1.40; 95% CI, -1.81 to -0.99; P < .0001), mesenteric (SMD = -1.21; 95% CI, -1.81 to -0.62; P < .0001), and retroperitoneal (SMD = -1.47; 95% CI, -1.94 to -0.99; P < .0001) regions in animals and waist circumference (SMD = -0.55; 95% CI, -1.06 to -0.44; P = .0336) in humans. Ellagic acid improves lipid profiles, reduces fat weight, and optimizes anthropometric parameters in animals and humans with metabolic marker abnormalities or pre-obesity, highlighting its therapeutic potential for managing metabolic syndrome and associated health conditions. Systematic Review Registration: PROSPERO no. CRD42024584248.