ABCB1基因C3435T多态性与他汀类药物治疗的高胆固醇血症患者的降脂反应：一项荟萃分析。
ABCB1 C3435T polymorphism and the lipid-lowering response in hypercholesterolemic patients on statins: a meta-analysis.
作者信息
Su Jia, Xu Hongyu, Yang Jun, Yu Qinglin, Yang Shujun, Zhang Jianjiang, Yao Qi, Zhu Yunyun, Luo Yuan, Ji Lindan, Zheng Yibo, Yu Jingbo
机构信息
Department of Gerontology, Ningbo No.1 Hospital, Ningbo, Zhejiang Province, 315010, People's Republic of China.
Department of Traditional Chinese Internal Medicine, Ningbo No.1 Hospital, Ningbo, Zhejiang Province, People's Republic of China.
出版信息
Lipids Health Dis. 2015 Oct 6;14:122. doi: 10.1186/s12944-015-0114-2.
BACKGROUND
A number of researches have evaluated the association between the ABCB1 polymorphism and the lipid-lowering response of statins, but the results have been inconclusive. To examine the lipid-lowering efficacy and safety associated with the ABCB1 C3435T polymorphism in hypercholesterolemic patients receiving statin, all available studies were included in this meta-analysis.
METHODS
A systematic search for eligible studies in the Cochrane library database, Scopus and PubMed was performed. Articles meeting the inclusion criteria were comprehensively reviewed, and the available data were accumulated by the meta-analysis.
RESULTS
The results indicated that the comparisons of CC+CT vs. TT were associated with a significant elevation of the serum HDL-C levels after statin treatment (CC+CT vs. TT: MD, 2.46; 95 % CI, 0.36 to 4.55; P = 0.02), and the ABCB1 C3435T variant in homozygotes was correlated with decreases in LDL-C (CC vs. TT: MD, 2.29; 95 % CI, 0.37 to 4.20; P = 0.02) as well as TC (CC vs. TT: MD, 3.05; 95 % CI, 0.58 to 5.53; P = 0.02) in patients treated with statin. However, we did not observe a significant association in the TG group or an association between other genetic models serum lipid parameters. In addition, statin treatment more than 5 months led to a higher risk of muscle toxicity.
CONCLUSIONS
The evidence from the meta-analysis demonstrated that the ABCB1 C3435T polymorphism may represent a pharmacogenomic biomarker for predicting treatment outcomes in patients on statins and that statin treatment for more than 5 months can increase the risk of myopathy.
背景
多项研究评估了ABCB1基因多态性与他汀类药物降脂反应之间的关联，但结果尚无定论。为了研究接受他汀类药物治疗的高胆固醇血症患者中ABCB1 C3435T基因多态性与降脂疗效及安全性的关系，本荟萃分析纳入了所有可用研究。
方法
在Cochrane图书馆数据库、Scopus和PubMed中系统检索符合条件的研究。对符合纳入标准的文章进行全面综述，并通过荟萃分析汇总可用数据。
结果
结果表明，他汀类药物治疗后，CC + CT与TT比较，血清高密度脂蛋白胆固醇（HDL-C）水平显著升高（CC + CT与TT比较：MD，2.46；95%CI，0.36至4.55；P = 0.02），纯合子中的ABCB1 C3435T变异与接受他汀类药物治疗患者的低密度脂蛋白胆固醇（LDL-C）降低相关（CC与TT比较：MD，2.29；95%CI，0.37至4.20；P = 0.02）以及总胆固醇（TC）降低相关（CC与TT比较：MD，3.05；95%CI，0.58至5.53；P = 0.02）。然而，我们在甘油三酯（TG）组中未观察到显著关联，也未观察到其他遗传模型与血脂参数之间的关联。此外，他汀类药物治疗超过5个月会导致更高的肌肉毒性风险。
结论
荟萃分析的证据表明，ABCB1 C3435T基因多态性可能是预测他汀类药物治疗患者治疗结局的药物基因组生物标志物，且他汀类药物治疗超过5个月会增加肌病风险。
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