Serum lipopolysaccharide binding protein (LBP) and metabolic syndrome: a systematic review and meta-analysis

Studies reported a link between the inflammatory background of metabolic syndrome (MetS) and endotoxemia. Assessing endotoxemia is typically done by measuring lipopolysaccharides binding protein (LBP). Here, we aimed to find the exact efficacy of LBP in discriminating MetS cases from healthy individuals.

A systematic literature review was performed in Embase, Web of Science, Scopus, PubMed, and Google Scholar up to the end of April 2024. We included all original studies that provided data comparing the serum LBP levels between MetS and non-MetS populations or the association between LBP concentration and MetS. The National Institute of Health (NIH) checklist was utilized to assess the quality of included studies.

Among 1930 records found in the initial search, 18 studies were included in the systematic review and 13 in the meta-analysis. All included reports had acceptable quality. Our findings showed significantly higher LBP levels among MetS compared to non-MetS individuals (SMD: 5.313 µg/ mL, 95% CI: 0.606 to 10.020, I² = 99.681). To address this high heterogeneity, subgroup analysis, and sensitivity analysis were performed. Additionally, most of the included items in this investigation showed that higher serum LBP levels significantly increased the risk of MetS. Based on the Egger test, a considerable publication bias was observed.

Our findings suggest a potential association between higher levels of LBP and MetS, with MetS cases exhibiting elevated LBP levels compared to non-MetS participants. However, due to the high heterogeneity observed across studies, the influence of individual studies on the overall results, and the possibility of publication bias, these findings should be interpreted with caution.