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阿托伐他汀治疗中国 2 型糖尿病患者颈动脉内膜中层厚度:一项荟萃分析。

Atorvastatin Treatment for Carotid Intima-Media Thickness in Chinese Patients With Type 2 Diabetes: A Meta-Analysis.

作者信息

Fang Na, Han Wei, Gong Dandan, Fan Yu

机构信息

From the Institute of Molecular Biology and Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, PR China (NF, DG, ZC, YF); and Department of Pharmacy, Shenyang Children's Hospital, Shenyang, PR China (WH).

出版信息

Medicine (Baltimore). 2015 Nov;94(44):e1920. doi: 10.1097/MD.0000000000001920.

Abstract

Impact of atorvastatin on carotid intima-media thickness (CIMT) in patients with type 2 diabetes is still debating.The aim of our study is to investigate atorvastatin as adjuvant treatment on CIMT in Chinese patients with type 2 diabetes by conducting a meta-analysis based on the randomized controlled trials (RCTs).A systematic search of electronic database of the Pubmed, EMBASE, Cochrane Library, VIP database, China National Knowledge Infrastructure, and Wangfang up to January 2015 was conducted. Randomized controlled trials (RCTs) comparing atorvastatin adjuvant treatment to the hypoglycemic therapies or high-dose atorvastatin versus low-dose atorvastatin therapies for patients with type 2 diabetes were selected.A total of 14 RCTs involving 1345 patients were included. Adjuvant treatment with atorvastatin was associated with a significant reduction in CIMT (weighted mean difference [WMD] = -0.17 mm; 95% confidence interval [CI] -0.22 to -0.12). Compared with the low-dose atorvastatin, high-dose atorvastatin treatment was associated with a significant reduction in CIMT (WMD = -0.17 mm; 95% CI: -0.32 to -0.02). Adjuvant treatment with atorvastatin reduced serum total cholesterol, triglyceride, low-density lipoproteins, and high sensitivity C-reactive protein levels. However, atorvastatin had no significant impact on blood glucose levels.This meta-analysis demonstrated that treatment with atorvastatin significantly reduced CIMT in Chinese patients with type 2 diabetes. Moreover, high-dose atorvastatin appeared to have additional benefits in reducing CIMT than the low-dose atorvastatin.

摘要

阿托伐他汀对2型糖尿病患者颈动脉内膜中层厚度(CIMT)的影响仍存在争议。我们研究的目的是通过基于随机对照试验(RCT)进行荟萃分析,探讨阿托伐他汀作为辅助治疗对中国2型糖尿病患者CIMT的影响。对截至2015年1月的Pubmed、EMBASE、Cochrane图书馆、维普数据库、中国知网和万方的电子数据库进行了系统检索。选择了比较阿托伐他汀辅助治疗与降糖治疗或高剂量阿托伐他汀与低剂量阿托伐他汀治疗2型糖尿病患者的随机对照试验(RCT)。共纳入14项涉及1345例患者的RCT。阿托伐他汀辅助治疗与CIMT显著降低相关(加权平均差[WMD]=-0.17mm;95%置信区间[CI]-0.22至-0.12)。与低剂量阿托伐他汀相比,高剂量阿托伐他汀治疗与CIMT显著降低相关(WMD=-0.17mm;95%CI:-0.32至-0.02)。阿托伐他汀辅助治疗可降低血清总胆固醇、甘油三酯、低密度脂蛋白和高敏C反应蛋白水平。然而,阿托伐他汀对血糖水平无显著影响。这项荟萃分析表明,阿托伐他汀治疗可显著降低中国2型糖尿病患者的CIMT。此外,高剂量阿托伐他汀在降低CIMT方面似乎比低剂量阿托伐他汀有额外的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4865/4915894/e201932c155c/medi-94-e1920-g001.jpg

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