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.
Atherosclerosis. 2016 Oct;253:194-208. doi: 10.1016/j.atherosclerosis.2016.07.897. Epub 2016 Jul 15.
The effect of statin therapy on plasma adiponectin levels has not been conclusively studied. Therefore, we aimed to evaluate this effect through a systematic review and meta-analysis of available randomized controlled trials (RCTs).
Quantitative data synthesis was performed using a random-effects model with weighted mean difference (WMD) and 95% confidence interval (CI) as summary statistics.
In 30 studies (43 study arms) with 2953 participants, a significant increase in plasma adiponectin levels was observed after statin therapy (WMD: 0.57 μg/mL, 95% CI: 0.18, 0.95, p = 0.004). In subgroup analysis, atorvastatin, simvastatin, rosuvastatin, pravastatin and pitavastatin were found to change plasma adiponectin concentrations by 0.70 μg/mL (95% CI: -0.26, 1.65), 0.50 μg/mL (95% CI: -0.44, 1.45), -0.70 μg/mL (95% CI: -1.08, -0.33), 0.62 μg/mL (95% CI: -0.12, 1.35), and 0.51 μg/mL (95% CI: 0.30, 0.72), respectively. With respect to duration of treatment, there was a significant increase in the subset of trials lasting ≥12 weeks (WMD: 0.88 μg/mL, 95% CI: 0.19, 1.57, p = 0.012) but not in the subset of <12 weeks of duration (WMD: 0.18 μg/mL, 95% CI: -0.23, 0.58, p = 0.390). Random-effects meta-regression suggested a significant association between statin-induced elevation of plasma adiponectin and changes in plasma low density lipoprotein cholesterol levels (slope: 0.04; 95% CI: 0.01, 0.06; p = 0.002).
The meta-analysis showed a significant increase in plasma adiponectin levels following statin therapy. Although statins are known to increase the risk for new onset diabetes mellitus, our data might suggest that the mechanism for this is unlikely to be due to a reduction in adiponectin expression.
他汀类药物治疗对血浆脂联素水平的影响尚未得出明确结论。因此，我们旨在通过对现有随机对照试验（RCT）的系统评价和荟萃分析来评估这种影响。
使用随机效应模型和加权均数差值（WMD）和 95%置信区间（CI）作为汇总统计量进行定量数据分析。
在 30 项研究（43 个研究臂）共 2953 名参与者中，他汀类药物治疗后血浆脂联素水平显著升高（WMD：0.57μg/mL，95%CI：0.18，0.95，p=0.004）。在亚组分析中，阿托伐他汀、辛伐他汀、瑞舒伐他汀、普伐他汀和匹伐他汀分别使血浆脂联素浓度变化 0.70μg/mL（95%CI：-0.26，1.65）、0.50μg/mL（95%CI：-0.44，1.45）、-0.70μg/mL（95%CI：-1.08，-0.33）、0.62μg/mL（95%CI：-0.12，1.35）和 0.51μg/mL（95%CI：0.30，0.72）。关于治疗持续时间，治疗持续时间≥12 周的亚组试验中（WMD：0.88μg/mL，95%CI：0.19，1.57，p=0.012），而在持续时间<12 周的亚组试验中（WMD：0.18μg/mL，95%CI：-0.23，0.58，p=0.390），无显著差异。随机效应荟萃回归表明，他汀类药物诱导的血浆脂联素升高与血浆低密度脂蛋白胆固醇水平的变化之间存在显著关联（斜率：0.04；95%CI：0.01，0.06；p=0.002）。
荟萃分析显示，他汀类药物治疗后血浆脂联素水平显著升高。虽然他汀类药物已知会增加新发糖尿病的风险，但我们的数据表明，这种机制不太可能是由于脂联素表达减少所致。
