Sahebkar Amirhossein, Reiner Zeljko, Simental-Mendia Luis E, Ferretti Gianna, Della Corte Claudia, Nobili Valerio
Chief of Hepatometabolic Department Head of Liver Research Unit "Bambino Gesu" Children's Hospital Pzza S Onofrio, 4 00165, Rome, Italy.
Curr Pharm Des. 2017;23(6):861-869. doi: 10.2174/1381612822666161006150542.
During recent years, treatment with statins has been suggested to induce several effect on bone status and vitamin D metabolism, interpreted as statins pleiotropic effects. Actually, the available data are not conclusive and the characteristics of this association remains unclear.
The purpose of this meta-analysis was therefore to investigate the possible effect of statins therapy on vitamin D serum levels based on the reported results from RCTs and observational studies.
PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases were searched to identify studies evaluating the impact of statins on plasma vitamin D concentrations from inception to September 16, 2015. A systematic assessment of bias in the included randomized controlled trials was performed using the Cochrane criteria. A random-effects model (using DerSimonian-Laird method) and the generic inverse variance method were used for the heterogeneity of studies in terms of demographic characteristics of populations being studied and also differences in study design and type of statin being studied. Sensitivity analysis was conducted using the leave-one-out method.
Following a multiple database search, 1422 published studies were identified; among these, 7 studies were found to be eligible and included in the systematic review and meta-analysis. Our meta-analysis of data from seven studies (including 5 RCTs) did not indicate any significant effect of statins treatment on plasma vitamin D levels.
Further well-designed trials are necessary to confirm these results and to define better a possible relationship between statins and vitamin D levels.
近年来,有研究表明他汀类药物治疗对骨状态和维生素D代谢有多种影响,这被解释为他汀类药物的多效性作用。实际上,现有数据并不确凿,这种关联的特征仍不清楚。
因此,本荟萃分析的目的是根据随机对照试验(RCT)和观察性研究报告的结果,探讨他汀类药物治疗对血清维生素D水平的可能影响。
检索了PubMed-Medline、SCOPUS、Web of Science和谷歌学术数据库,以确定从研究开始至2015年9月16日评估他汀类药物对血浆维生素D浓度影响的研究。使用Cochrane标准对纳入的随机对照试验中的偏倚进行系统评估。对于所研究人群的人口统计学特征、研究设计差异以及所研究他汀类药物类型方面的研究异质性,采用随机效应模型(使用DerSimonian-Laird方法)和通用逆方差法。采用逐一剔除法进行敏感性分析。
经过多个数据库检索,共识别出1422项已发表的研究;其中,7项研究被认为符合条件并纳入系统评价和荟萃分析。我们对7项研究(包括5项RCT)的数据进行的荟萃分析未表明他汀类药物治疗对血浆维生素D水平有任何显著影响。
需要进一步设计良好的试验来证实这些结果,并更好地确定他汀类药物与维生素D水平之间可能存在的关系。