Analysis of vitamin D levels in patients with and without statin-associated myalgia - A systematic review and meta-analysis of 7 studies with 2420 patients
Analysis of vitamin D levels in patients with and without statin-associated myalgia - A systematic review and meta-analysis of 7 studies with 2420 patients
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DOI：
10.1016/j.ijcard.2014.10.118
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发表时间：
2015-01-15
影响因子：
3.5
通讯作者：
Banach, Maciej
中科院分区：
文献类型：
--
作者：
Michalska-Kasiczak, Marta;Sahebkar, Amirhossein;Banach, Maciej
简介：维生素 D (vit D) 缺乏可能与接受他汀类药物治疗的患者发生他汀类药物相关症状性肌痛的风险增加有关。本荟萃分析的目的是证实血清维生素 D 水平在他汀类药物相关肌痛中的作用。 方法：检索包括 1987 年 1 月 1 日至 2014 年 4 月 1 日期间的 PUBMED、Cochrane Library、Scopus 和 EMBASE，以识别研究维生素 D 水平对有或没有肌痛的他汀类药物治疗受试者的影响的研究。两名独立评审员提取了有关研究特征、方法和结果的数据。使用固定效应模型进行定量数据合成。结果：电子检索产生437篇文章；其中 20 项研究作为全文进行了审查，其中 13 项研究被认为不合适。最终分析包括 7 项研究，涉及 2420 名接受他汀类药物治疗的患者，分为有肌痛 (n = 666 [27.5%]) 或无肌痛 (n = 1754) 的患者亚组。有症状和无症状亚组的血浆维生素 D 浓度分别为 28.4 +/- 13.80 ng/mL 和 34.86 +/- 11.63 ng/mL。结合各个观察性研究的数据表明，与没有表现出这种副作用的患者相比，他汀类药物相关肌痛患者的血浆维生素 D 浓度显着降低（加权平均差 -9.41 ng/mL；95% 置信区间：-10.17 至 -8.64；p < 0.00001）。 结论：这项荟萃分析提供的证据表明，低维生素 D 水平与接受他汀类药物治疗的患者的肌痛相关。需要进行随机对照试验来确定补充维生素 D 是否可以降低他汀类药物相关肌痛的风险。 (C) 2014 Elsevier Ireland Ltd. 保留所有权利。
Introduction: Vitamin D (vit D) deficiency may be associated with an increased risk of statin-related symptomatic myalgia in statin-treated patients. The aim of this meta-analysis was to substantiate the role of serum vitamin D levels in statin-associated myalgia.Methods: The search included PUBMED, Cochrane Library, Scopus, and EMBASE from January 1, 1987 to April 1, 2014 to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. Two independent reviewers extracted data on study characteristics, methods and outcomes. Quantitative data synthesis was performed using a fixed-effect model.Results: The electronic search yielded 437 articles; of those 20 were scrutinized as full texts and 13 studies were considered unsuitable. The final analysis included 7 studies with 2420 statin-treated patients divided into subgroups of patients with (n = 666 [27.5%]) or without (n = 1754) myalgia. Plasma vit D concentrations in the symptomatic and asymptomatic subgroups were 28.4 +/- 13.80 ng/mL and 34.86 +/- 11.63 ng/mL, respectively. The combination of data fromindividual observational studies showed that vit D plasma concentrations were significantly lower in patients with statin-associated myalgia compared with patients not manifesting this side effect (weighted mean difference -9.41 ng/mL; 95% confidence interval: -10.17 to -8.64; p < 0.00001).Conclusions: This meta-analysis provides evidence that low vit D levels are associated with myalgia in patients on statin therapy. Randomized controlled trials are necessary to establish whether vitamin D supplementation reduces the risk for statin-associated myalgia. (C) 2014 Elsevier Ireland Ltd. All rights reserved.