{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T17:23:28Z","timestamp":1781803408868,"version":"3.54.5"},"reference-count":51,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"West China Nursing Discipline Development Special Fund Project","award":["HXHL21003"],"award-info":[{"award-number":["HXHL21003"]}]},{"name":"Technology and Training of Sichuan Province","award":["2021JDKP0043"],"award-info":[{"award-number":["2021JDKP0043"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,3,14]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the associations between alpha-lipoic acid (ALA) intake and intermediate disease markers in overweight or obese adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed, EMBASE, Medline, APA PsycINFO, SocINDEX, CINAHL, SSRN, SocArXiv, PsyArXiv, medRxiv, and Google Scholar (from inception to October 2024).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>This study included English-language randomised controlled trials (RCTs) on adults (body mass index \u226525\u2009kg\/m\u00b2) to assess the impact of ALA on intermediate disease markers. Studies lacking outcome data, duplicates or inaccessible full texts were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Paired reviewers independently extracted the data. We used frequentist meta-analysis to summarise the evidence, employing the DerSimonian and Laird estimator to account for heterogeneity across study designs, settings and measurement methods. Heterogeneity was assessed via the I\u00b2 statistic with CIs and \u03c4\u00b2 values. The risk of bias was independently assessed by two reviewers according to the Cochrane Handbook, covering domains such as randomisation, blinding and data completeness. Publication bias was assessed using Begg\u2019s test, while funnel plots and Egger\u2019s test were applied to outcomes with 10 or more studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This meta-analysis included 11 RCTs from an initial screening of 431 studies, encompassing a total of 704 adults. The meta-analysis results revealed no significant associations were detected between ALA supplementation and changes in intermediate disease markers, including triglyceride (TG) (standardised mean difference (SMD): \u22120.08, 95%\u2009CI: \u22120.24 to 0.09, p=0.36, I\u00b2=0.00%, \u03c4\u00b2=0.00), total cholesterol (TC) (SMD: 0.08, 95%\u2009CI: \u22120.55 to 0.71, p=0.80, I\u00b2=87.50%, \u03c4\u00b2=0.52), high-density lipoprotein cholesterol (HDL-C) (SMD: \u22120.05, 95%\u2009CI: \u22120.22 to 0.11, p=0.52, I\u00b2=0.00%, \u03c4\u00b2=0.00), low-density lipoprotein cholesterol (LDL-C) (SMD: \u22120.13, 95%\u2009CI: \u22120.40 to 0.15, p=0.37, I\u00b2=0.00%, \u03c4\u00b2=0.00), homeostasis model assessment of insulin resistance (HOMA-IR) (SMD: \u22120.23, 95%\u2009CI: \u22120.60 to 0.15, p=0.23, I\u00b2=26.20%, \u03c4\u00b2=0.05) and fasting blood glucose (FBS) (SMD: 0.13, 95%\u2009CI: \u22120.16 to 0.41, p=0.39, I\u00b2=29.40%, \u03c4\u00b2=0.04). According to the Grading of Recommendations Assessment, Development and Evaluation bias assessment approach, eight studies were rated as having low bias (grade A), and three studies were rated as having moderate bias (grade B). Begg\u2019s test indicated no evidence of publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No significant associations were detected between ALA intake and intermediate disease markers, including TG, TC, HDL-C, LDL-C, HOMA-IR and FBS levels, in overweight or obese adults. Further research is needed to explore the potential associations of ALA, especially in high-risk populations with metabolic disorders, by employing longer intervention durations, higher dosages and optimised formulations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42023450239.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-088363","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T21:53:59Z","timestamp":1743717239000},"page":"e088363","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Alpha-lipoic acid on intermediate disease markers in overweight or obese adults: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4696-0209","authenticated-orcid":false,"given":"Yao","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Nursing, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jizhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nursing, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxia","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Nursing, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"2025121513153722000_15.4.e088363.1","unstructured":"WHO Reports 2021 . WHO obesity and overweight. 2021."},{"key":"2025121513153722000_15.4.e088363.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30054-X"},{"key":"2025121513153722000_15.4.e088363.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0065174","article-title":"The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis","volume":"8","author":"Singh","year":"2013","journal-title":"PLoS One"},{"key":"2025121513153722000_15.4.e088363.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2011.00879.x"},{"key":"2025121513153722000_15.4.e088363.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejphar.2019.01.001","article-title":"Does alpha-lipoic acid affect lipid profile? A meta-analysis and systematic review on randomized controlled trials","volume":"847","author":"Haghighatdoost","year":"2019","journal-title":"Eur J Pharmacol"},{"key":"2025121513153722000_15.4.e088363.6","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0803715"},{"key":"2025121513153722000_15.4.e088363.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2010.00825.x"},{"key":"2025121513153722000_15.4.e088363.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2017.04.028"},{"key":"2025121513153722000_15.4.e088363.9","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1002\/2327-6924.12519","article-title":"Current pharmacotherapies for obesity: A practical perspective","volume":"29","author":"Golden","year":"2017","journal-title":"J Am Assoc Nurse Pract"},{"key":"2025121513153722000_15.4.e088363.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2009.07.003"},{"key":"2025121513153722000_15.4.e088363.11","doi-asserted-by":"publisher","DOI":"10.2174\/138161210790883589"},{"key":"2025121513153722000_15.4.e088363.12","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/biof.5520170120","article-title":"Lipoic acid: a multifunctional antioxidant","volume":"17","author":"Bast","year":"2003","journal-title":"Biofactors"},{"key":"2025121513153722000_15.4.e088363.13","doi-asserted-by":"publisher","DOI":"10.1089\/15209150050194279"},{"key":"2025121513153722000_15.4.e088363.14","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.amjmed.2010.08.005","article-title":"Effects of alpha-lipoic Acid on body weight in obese subjects","volume":"124","author":"Koh","year":"2011","journal-title":"Am J Med"},{"key":"2025121513153722000_15.4.e088363.15","doi-asserted-by":"crossref","DOI":"10.3390\/nu11020375","article-title":"Effect of Alpha-Lipoic Acid Supplementation on Endothelial Function and Cardiovascular Risk Factors in Overweight\/Obese Youths: A Double-Blind, Placebo-Controlled Randomized Trial","volume":"11","author":"Tromba","year":"2019","journal-title":"Nutrients"},{"key":"2025121513153722000_15.4.e088363.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2005.05.035"},{"key":"2025121513153722000_15.4.e088363.17","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s00394-012-0384-7","article-title":"Effects of lipoic acid on AMPK and adiponectin in adipose tissue of low- and high-fat-fed rats","volume":"52","author":"Prieto-Hontoria","year":"2013","journal-title":"Eur J Nutr"},{"key":"2025121513153722000_15.4.e088363.18","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.metabol.2018.07.002","article-title":"The effects of alpha-lipoic acid supplementation on glucose control and lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials","volume":"87","author":"Akbari","year":"2018","journal-title":"Metab Clin Exp"},{"key":"2025121513153722000_15.4.e088363.19","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.clnesp.2019.03.015","article-title":"Alpha-lipoic acid (ALA) supplementation effect on glycemic and inflammatory biomarkers: A Systematic Review and meta- analysis","volume":"32","author":"Rahimlou","year":"2019","journal-title":"Clin Nutr ESPEN"},{"key":"2025121513153722000_15.4.e088363.20","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.clnu.2017.06.002","article-title":"Alpha-lipoic acid supplement in obesity treatment: A systematic review and meta-analysis of clinical trials","volume":"37","author":"Namazi","year":"2018","journal-title":"Clin Nutr"},{"key":"2025121513153722000_15.4.e088363.21","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1111\/obr.12528","article-title":"Alpha-lipoic acid (ALA) as a supplementation for weight loss: results from a meta-analysis of randomized controlled trials","volume":"18","author":"Kucukgoncu","year":"2017","journal-title":"Obes Rev"},{"key":"2025121513153722000_15.4.e088363.22","doi-asserted-by":"crossref","DOI":"10.1111\/ijcp.13493","article-title":"Alpha-lipoic acid supplementation significantly reduces the risk of obesity in an updated systematic review and dose response meta-analysis of randomised placebo-controlled clinical trials","volume":"74","author":"Vajdi","year":"2020","journal-title":"Int J Clin Pract"},{"key":"2025121513153722000_15.4.e088363.23","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00316-4"},{"key":"2025121513153722000_15.4.e088363.24","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-023-01625-2"},{"key":"2025121513153722000_15.4.e088363.25","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-025-87416-7","article-title":"Joint association of TyG index and LDL-C with all-cause and cardiovascular mortality among patients with cardio-renal-metabolic disease","volume":"15","author":"Lai","year":"2025","journal-title":"Sci Rep"},{"key":"2025121513153722000_15.4.e088363.26","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.19.2486"},{"key":"2025121513153722000_15.4.e088363.27","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000678"},{"key":"2025121513153722000_15.4.e088363.28","doi-asserted-by":"crossref","DOI":"10.1016\/j.atherosclerosis.2025.119139","article-title":"Discordance analyses comparing LDL cholesterol, Non-HDL cholesterol, and apolipoprotein B for cardiovascular risk estimation","volume":"403","author":"Johannesen","year":"2025","journal-title":"Atherosclerosis"},{"key":"2025121513153722000_15.4.e088363.29","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab432"},{"key":"2025121513153722000_15.4.e088363.30","doi-asserted-by":"crossref","DOI":"10.1186\/s12944-025-02492-y","article-title":"Association between metabolic score for insulin resistance (METS-IR) and hypertension: a cross-sectional study based on NHANES 2007-2018","volume":"24","author":"Guo","year":"2025","journal-title":"Lipids Health Dis"},{"key":"2025121513153722000_15.4.e088363.31","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2008.351"},{"key":"2025121513153722000_15.4.e088363.32","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2025121513153722000_15.4.e088363.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.09.011"},{"key":"2025121513153722000_15.4.e088363.34","unstructured":"Aslfalah S . The effects of alpha-lipoic acid on lipid profiles and blood pressure in adults: a systematic review and meta-analysis. J Clin Lipidol 2019;420\u201331."},{"key":"2025121513153722000_15.4.e088363.35","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.clnesp.2023.02.016","article-title":"Clinical effectiveness of \u03b1-lipoic acid, myo-inositol and propolis supplementation on metabolic profiles and liver function in obese patients with NAFLD: A randomized controlled clinical trial","volume":"54","author":"Tutunchi","year":"2023","journal-title":"Clin Nutr ESPEN"},{"key":"2025121513153722000_15.4.e088363.36","doi-asserted-by":"crossref","DOI":"10.1096\/fj.202001817RR","article-title":"Alpha-lipoic acid supplementation increases the efficacy of exercise- and diet-induced obesity treatment and induces immunometabolic changes in female mice and women","volume":"35","author":"Le Garf","year":"2021","journal-title":"FASEB J"},{"key":"2025121513153722000_15.4.e088363.37","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1093\/jn\/nxaa203","article-title":"A Randomized Controlled Trial of Long-Term (R)-\u03b1-Lipoic Acid Supplementation Promotes Weight Loss in Overweight or Obese Adults without Altering Baseline Elevated Plasma Triglyceride Concentrations","volume":"150","author":"Bobe","year":"2020","journal-title":"J Nutr"},{"key":"2025121513153722000_15.4.e088363.38","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1111\/jcpt.12784","article-title":"The effect of alpha-lipoic acid on inflammatory markers and body composition in obese patients with non-alcoholic fatty liver disease: A randomized, double-blind, placebo-controlled trial","volume":"44","author":"Hosseinpour-Arjmand","year":"2019","journal-title":"J Clin Pharm Ther"},{"key":"2025121513153722000_15.4.e088363.39","doi-asserted-by":"crossref","first-page":"5732","DOI":"10.1039\/C9FO00390H","article-title":"Metabolic effects of \u03b1-lipoic acid supplementation in pre-diabetics: a randomized, placebo-controlled pilot study","volume":"10","author":"Gosselin","year":"2019","journal-title":"Food Funct"},{"key":"2025121513153722000_15.4.e088363.40","doi-asserted-by":"crossref","first-page":"4941","DOI":"10.1039\/C9FO00449A","article-title":"Oral \u03b1-lipoic acid supplementation in patients with non-alcoholic fatty liver disease: effects on adipokines and liver histology features","volume":"10","author":"Rahmanabadi","year":"2019","journal-title":"Food Funct"},{"key":"2025121513153722000_15.4.e088363.41","doi-asserted-by":"crossref","DOI":"10.1186\/s12944-018-0750-4","article-title":"Untargeted metabolomic on urine samples after \u03b1-lipoic acid and\/or eicosapentaenoic acid supplementation in healthy overweight\/obese women","volume":"17","author":"Romo-Hualde","year":"2018","journal-title":"Lipids Health Dis"},{"key":"2025121513153722000_15.4.e088363.42","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1111\/cen.13303","article-title":"Effects of oral \u03b1-lipoic acid administration on body weight in overweight or obese subjects: a crossover randomized, double-blind, placebo-controlled trial","volume":"86","author":"Li","year":"2017","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025121513153722000_15.4.e088363.43","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20966"},{"key":"2025121513153722000_15.4.e088363.44","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2011.121"},{"key":"2025121513153722000_15.4.e088363.45","first-page":"453","article-title":"Alpha-lipoic acid as a new treatment option","volume":"18","author":"Rahimlou","year":"2019","journal-title":"J Diabetes Metab Disord"},{"key":"2025121513153722000_15.4.e088363.46","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1139\/cjpp-2014-0480","article-title":"\u03b1-Lipoic acid as a triglyceride-lowering nutraceutical","volume":"93","author":"Pashaj","year":"2015","journal-title":"Can J Physiol Pharmacol"},{"key":"2025121513153722000_15.4.e088363.47","first-page":"82","article-title":"Oxidative stress and inflammation in hypertriglyceridaemia","volume":"12","author":"Bingham","year":"2014","journal-title":"Metab Syndr Relat Disord"},{"key":"2025121513153722000_15.4.e088363.48","doi-asserted-by":"crossref","DOI":"10.3390\/antiox9101011","article-title":"Safety Evaluation of \u03b1-Lipoic Acid Supplementation: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Clinical Studies","volume":"9","author":"Fogacci","year":"2020","journal-title":"Antioxidants (Basel)"},{"key":"2025121513153722000_15.4.e088363.49","first-page":"433","article-title":"Alpha-lipoic acid treatment improves insulin sensitivity","volume":"61","author":"Sun","year":"2012","journal-title":"Metab Clin Exp"},{"key":"2025121513153722000_15.4.e088363.50","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.2008.08k033"},{"key":"2025121513153722000_15.4.e088363.51","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbagen.2009.07.026"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-088363","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:15:46Z","timestamp":1765833346000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-088363"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":51,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,3]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bmjopen-2024-088363"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-088363","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}