The effects of ursodeoxycholic acid on cardiometabolic risk factors: a systematic review and meta-analysis of randomized controlled trials

BMC Cardiovasc Disord. 2025 Feb 21;25(1):125. doi: 10.1186/s12872-025-04549-3.

Abstract

Background: Chronic diseases such as obesity, hypertension, and metabolic syndrome are major health concerns worldwide. Ursodeoxycholic acid (UDCA) is a bile acid that is naturally produced in the liver and has been used for the treatment of various liver disorders. In this systematic review and meta-analysis, we investigated how UDCA might affect inflammation, blood pressure, and obesity.

Methods: Five major databases were searched from inception to August 2024. The investigated outcomes included body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). A random effect was carried out to estimate pooled weighted mean difference (WMD) with 95% confidence intervals (CI). The registration code is CRD42023428064.

Results: Of the 7912 articles in the initial search, 12 were included in the systematic review and meta-analysis. UDCA consumption significantly decreased BMI (WMD: -0.29 kg/m2, 95% CI: -0.58, -0.01, P = 0.044), and DBP (WMD: -2.16 mmHg, 95% CI: -3.66, -0.66, P = 0.005). It also increased SBP (WMD: 5.50 mmHg, 95% CI: 3.65, 7.35, P < 0.001); however, it was not associated with weight loss (WMD: -0.3 kg, 95% CI: -1.3, 0.71, P = 0.561). Our systematic review showed that UDCA consumption has no effect on IL-6 and TNF-α.

Conclusion: This systematic review and meta-analysis suggest that UDCA supplementation may improve BMI and DBP, whereas it may increase SBP and have no effect on weight or inflammation. Further long-term and well-designed RCTs are needed to further assess and confirm these results.

Keywords: Blood pressure; Body weight; Inflammation; Meta-analysis; Ursodeoxycholic acid.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents* / adverse effects
  • Anti-Inflammatory Agents* / therapeutic use
  • Biomarkers / blood
  • Blood Pressure* / drug effects
  • Cardiometabolic Risk Factors*
  • Cholagogues and Choleretics* / adverse effects
  • Cholagogues and Choleretics* / therapeutic use
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Hypertension* / physiopathology
  • Inflammation Mediators / blood
  • Interleukin-6
  • Male
  • Metabolic Syndrome* / blood
  • Metabolic Syndrome* / diagnosis
  • Metabolic Syndrome* / drug therapy
  • Metabolic Syndrome* / epidemiology
  • Metabolic Syndrome* / physiopathology
  • Metabolic Syndrome* / prevention & control
  • Middle Aged
  • Obesity* / diagnosis
  • Obesity* / drug therapy
  • Obesity* / epidemiology
  • Obesity* / physiopathology
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / blood
  • Ursodeoxycholic Acid* / adverse effects
  • Ursodeoxycholic Acid* / therapeutic use

Substances

  • Ursodeoxycholic Acid
  • Cholagogues and Choleretics
  • Inflammation Mediators
  • IL6 protein, human
  • Biomarkers
  • Tumor Necrosis Factor-alpha
  • Anti-Inflammatory Agents
  • Interleukin-6