The effect of tibolone treatment on lipid profile in women: A systematic review and dose-response meta-analysis of randomized controlled trials

Abstract

Inconsistencies exist with regard to influence of tibolone treatment on the lipid profile. The reasons for these inconsistencies might derive from several factors, i.e., differences in baseline variables, intervention duration, participants’ health status or baseline body mass index (BMI). To address these inconsistencies, based on a systematic search in Scopus, PubMed/Medline, Web of Science, and Embase for papers published until 21 December 2020, we conducted the current dose-response meta-analysis of randomized controlled trials (RCTs) to determine the impact of tibolone treatment on the lipid profile. The overall findings were derived from 26 RCTs. Tibolone administration decreased total cholesterol (TC) (weighted mean difference, WMD: −18.55 mg/dL, CI: −25.95 to −11.16, P < 0.001), high-density lipoprotein-cholesterol (HDL-C) (WMD: −9.42 mg/dL, CI: −11.83 to −7.01, P < 0.001) and triglyceride (TG) (WMD: −21.43 mg/dL, CI: −27.15 to −15.70, P < 0.001) levels. A significant reduction in LDL-C occurred when tibolone was prescribed for ≤ 26 weeks (WMD: −7.64 mg/dL, 95% CI: −14.58 to −0.70, P = 0.031) versus > 26 weeks (WMD: −8.84 mg/dL, 95% CI: −29.98, 12.29, P = 0.412). The decrease in TG (WMD: −22.64 mg/dL) and TC (−18.55 mg/dL) concentrations was more pronounced in patients with BMI ≥ 25 kg/m2 versus BMI < 25 kg/m2. This systematic review and meta-analysis discovered that tibolone decreases TC, HDL-C and TG levels. LDL-C concentrations are significantly reduced when tibolone administration lasts for ≤ 26 weeks.