Michalska-Kasiczak Marta, Sahebkar Amirhossein, Mikhailidis Dimitri P, Rysz Jacek, Muntner Paul, Toth Peter P, Jones Steven R, Rizzo Manfredi, Kees Hovingh G, Farnier Michel, Moriarty Patrick M, Bittner Vera A, Lip Gregory Y H, Banach Maciej
Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland.
Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
Int J Cardiol. 2015 Jan 15;178:111-6. doi: 10.1016/j.ijcard.2014.10.118. Epub 2014 Oct 22.
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.
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.
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±13.80ng/mL and 34.86±11.63ng/mL, respectively. The combination of data from individual 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 -9.41ng/mL; 95% confidence interval: -10.17 to -8.64; p<0.00001).
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.
维生素D（vit D）缺乏可能与他汀类药物治疗患者发生他汀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水平在他汀相关肌痛中的作用。
检索1987年1月1日至2014年4月1日期间的PUBMED、Cochrane图书馆、Scopus和EMBASE，以确定研究维生素D水平对有或无肌痛的他汀治疗受试者影响的研究。两名独立评审员提取了关于研究特征、方法和结果的数据。使用固定效应模型进行定量数据合成。
电子检索得到437篇文章；其中20篇作为全文进行了审查，13项研究被认为不合适。最终分析包括7项研究，共2420例他汀治疗患者，分为有肌痛（n = 666 [27.5%]）或无肌痛（n = 1754）的亚组。有症状和无症状亚组的血浆vit D浓度分别为28.4±13.80ng/mL和34.86±11.63ng/mL。个体观察性研究的数据合并显示，与未出现这种副作用的患者相比，他汀相关肌痛患者的vit D血浆浓度显著更低（加权平均差 -9.41ng/mL；95%置信区间：-10.17至-8.64；p<0.00001）。
本荟萃分析提供了证据，表明低vit D水平与他汀治疗患者的肌痛有关。需要进行随机对照试验来确定补充维生素D是否能降低他汀相关肌痛的风险。
