Key result
Thiazolidinediones reduce VAT vs placebo and sulfonylureas while increasing subcutaneous and total body fat.
Why the study?
Visceral adiposity strongly predicts cardiometabolic risk and thiazolidinediones shift fat from visceral to subcutaneous adipose tissue, but their comparative effects on fat remodeling in adults needed evaluation.
Do thiazolidinediones improve body fat redistribution and cardiometabolic risk markers compared to other interventions in adults?
Meta-Analysis (n=1,765)
Do thiazolidinediones improve body fat redistribution and cardiometabolic risk markers compared to other interventions in adults?
p-value: p=<0.05
Thiazolidinediones favorably alter fat redistribution by reducing visceral and liver fat while improving insulin sensitivity and lipid profiles, despite increasing overall weight and subcutaneous fat.
Supports TZD selection to target visceral adiposity; extends meta-analytic evidence on depot-specific fat effects.
Visceral adiposity is a strong predictor of cardiometabolic risk. Thiazolidinediones (TZDs) are associated with a shift in fat redistribution from visceral adipose tissue (VAT) to subcutaneous adipose tissue (SAT). We aimed to compare the effects of TZD and other interventions on fat remodeling in adults in randomized controlled trials. Among the 1331 retrieved studies, 39 trials with 1765 participants were included in the meta-analysis. The standardized mean difference in VAT change was not significantly different between TZD and comparators across the overall studies. Intriguingly, TZD treatment resulted in significant decreases in VAT compared with placebo and sulfonylureas (p < 0.05), although recombinant human growth hormone was superior to TZD regarding VAT reduction (p < 0.05). Data from 216 participants showed TZD leading to a greater reduction in liver fat percentage than comparators (p < 0.05). Compared with the controls, TZD significantly increased SAT, total body fat, weight, waist circumference, and body mass index (p < 0.05). However, TZD pronouncedly improved glucose control, insulin resistance, adiponectin, and lipid profile (p < 0.05). TZD provides a favorable effect on fat redistribution and benefits insulin sensitivity, suggesting a potentially valuable approach in cardiometabolic risk management.
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Zhang et al. (2023) conducted a meta-analysis in Visceral adiposity (n=1,765). Thiazolidinediones (TZDs) vs. Placebo, sulfonylureas, recombinant human growth hormone, and other controls was evaluated on Visceral adipose tissue (VAT) change (p=<0.05). Thiazolidinedione treatment significantly decreased visceral adipose tissue compared with placebo and sulfonylureas (p < 0.05), while increasing subcutaneous and total body fat.
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