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

ABSTRACT

BACKGROUND: The 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. METHODS: A 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. RESULTS: 35 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). CONCLUSIONS: The 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.