Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Biomed Res Int. 2018 Mar 5;2018:7092414. doi: 10.1155/2018/7092414. eCollection 2018.
Statin is a class of medications used to decrease low-density lipoprotein cholesterol level to prevent cardiovascular disease. However, the risk of hepatic damage caused by statin therapy is still controversial. We conducted a systematic review and meta-analysis summarizing the existing evidence of the effect of statin therapy on incidence of liver injury to clarify whether statin therapy could lead to liver function test abnormalities.
We searched the Cochrane Library, PubMed, and Embase database for the relevant studies update till Jan. 2017 regarding statin therapy and liver injury. Two researchers screened the literature independently by the selection and exclusion criteria. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using random effects models, and subgroup analyses were performed by study characteristics. This meta-analysis was performed by STATA 13.1 software.
Analyses were based on 74,078 individuals from 16 studies. The summary OR of statin therapy was 1.18 (95% CI: 1.01-1.39, = 0.04; = 0.0%) for liver injury. Subgroup analysis indicated that fluvastatin increased the risk of liver injury significantly (OR, 3.50; 95% CI: 1.07-11.53, = 0.039; = 0.0%) and dose over 40 mg/daily had an unfavorable effect on the liver damage (OR, 3.62; 95% CI: 1.52-8.65, = 0.004; = 0.0%). The sensitivity analysis indicated that the results were robust.
Our findings confirm that statin therapy substantially increases the risk of liver injury, especially using fluvastatin over 40 mg/d.
他汀类药物是一类用于降低低密度脂蛋白胆固醇水平以预防心血管疾病的药物。然而，他汀类药物治疗引起肝损伤的风险仍存在争议。我们进行了一项系统评价和荟萃分析，总结了他汀类药物治疗对肝损伤发生率影响的现有证据，以明确他汀类药物治疗是否会导致肝功能试验异常。
我们检索了 Cochrane 图书馆、PubMed 和 Embase 数据库，以获取截至 2017 年 1 月有关他汀类药物治疗与肝损伤的相关研究。两位研究者根据纳入和排除标准独立筛选文献。采用随机效应模型汇总比值比（OR）和 95%置信区间（CI），并按研究特征进行亚组分析。该荟萃分析采用 STATA 13.1 软件进行。
分析基于来自 16 项研究的 74078 名个体。他汀类药物治疗的汇总 OR 为 1.18（95%CI：1.01-1.39， = 0.04； = 0.0%），表明他汀类药物治疗与肝损伤相关。亚组分析表明，氟伐他汀显著增加肝损伤的风险（OR，3.50；95%CI：1.07-11.53， = 0.039； = 0.0%），且剂量超过 40mg/d 对肝损伤不利（OR，3.62；95%CI：1.52-8.65， = 0.004； = 0.0%）。敏感性分析表明结果稳健。
我们的研究结果证实，他汀类药物治疗显著增加肝损伤的风险，尤其是使用氟伐他汀超过 40mg/d 时。
