title: The effects of bile acid sequestrants on lipid profile and blood glucose concentrations: A systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To undertake a systematic review and meta-analysis of prospective clinical studies to determine the effect of bile acid sequestrants (BAS) on lipid profile and blood glucose concentrations.
  
  
  METHODS
  PubMed-Medline, Web of Science, Cochrane Database and Google Scholar databases were searched (up until August 2016) to identify prospective studies evaluating the impact of BASs on the cardio-metabolic profile. Random effects model meta-analysis was used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Heterogeneity was quantitatively assessed using the I2index. Systematic review registration: CRD42016035973.
  
  
  RESULTS
  From a total of 769 entries identified, 15 studies were included in the final analysis. The meta-analysis indicated a significant reduction in fasting serum triglyceride concentrations following treatment with BASs (weighted mean difference [WMD] 0.54mg/dL, 95% CI 0.43 to 0.65, heterogeneity p=0.021; I254.2%, n=11 studies). The WMDs for total serum cholesterol (TC) was -1.18mg/dL (95% CI -1.30 to -1.06, heterogeneity p=0012; I263.1%, n=11 studies), 0.126mg/dL (95% CI 0.02 to 0.22, heterogeneity p=0.231; I243.2%, n=11 studies) for HDL-cholesterol, and -0.24mg/dL (95% CI -0.35 to -0.14, heterogeneity p=0.562; I223.1%, n=10 studies) for LDL-cholesterol, and -2.10mg/dL (95% CI -2.84 to -1.36, heterogeneity p=0.200; I242.6%, n=11 studies) fasting blood glucose (FBG) and -0.83% (95% CI -1.08 to -0.57, heterogeneity p=0.856; I220.9%, n=11 studies) for HbA1c. These findings were robust in sensitivity analyses.
  
  
  CONCLUSIONS
  This meta-analysis suggests that therapy with BAS significantly improves HDL-C, LDL-C, and glycemic markers including fasting blood glucose, HbA1c levels, while deteriorating triglyceride levels.
authors.affiliation: Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China; Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, China. Electronic address: Moshen@genetics.ac.cn.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Mazidi
authors.affiliation: Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Peyman
authors.initials: P
authors.lastname: Rezaie
authors.affiliation: Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Karimi
authors.affiliation: Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; University of Cape Town, Cape Town, South Africa.
authors.forename: Andre Pascal
authors.initials: AP
authors.lastname: Kengne
mesh_terms: D000837:Anion Exchange Resins / Q000494:pharmacology*; D001647:Bile Acids and Salts / Q000037:antagonists & inhibitors; D001786:Blood Glucose / Q000032:analysis*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000837:Anion Exchange Resins; D001647:Bile Acids and Salts; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL
keywords: Bile acid sequestrants; Fasting blood glucose; Lipid profile; Meta-analysis