The impact of medroxyprogesterone acetate on lipid profiles in Women: A time and dose-response meta-analysis of randomized controlled trials

Abstract

BackgroundThe effect of MPA on the lipid profile and CVD risk is still controversial; hence, this comprehensive dose–response meta-analysis of randomized controlled trials was conducted to assess the effect of MPA on lipid profiles in women. MethodsA comprehensive search was conducted in the following databases: Web of Science, Scopus, PubMed/Medline, and Embase, up to October 20, 2023. A random-effects meta-analysis approach based on the DerSimonian and Laird method was used to compute the combined estimates of the intervention's impact on the lipid profile. Results35 eligible studies with 58 arms were included in our meta-analyses analysis. Combined effect sizes suggested a significant effect of MPA on total cholesterol (TC) levels (WMD: −3.43 mg/dL, 95 % CI: −5.38 to −1.48, p < 0.001), HDL-C levels (WMD: −3.34 mg/dL, 95 % CI: −3.77 to −2.91, p < 0.001), and triglyceride (TG) levels (WMD: −9.13 mg/dL, 95 % CI: −10.92 to −7.33, p < 0.001). The subgroup meta-analysis revealed a more substantial reduction in TC in studies with dosages > 2.5 mg/day (WMD: −4.10 mg/dL), mean participant age lower than 60 years (WMD: −3.80 mg/dL), mean BMI lower than 25 kg/m2 (WMD: −5.61 mg/dL), duration of intervention of 12 months or more (WMD: −3.98 mg/dL), and when the baseline TC value was equal to or greater than 200 mg/dL (WMD: −4.13 mg/dL). ConclusionsThe current meta-analysis showed a statistically significant decrease in TC, TG, and HDL-C levels and a non-significant increase in LDL-C levels after MPA administration in women.