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他汀类药物的使用与急性胰腺炎风险增加无关——观察性研究的荟萃分析

Statin use is not associated with an increased risk of acute pancreatitis-A meta-analysis of observational studies.

作者信息

Poropat Goran, Archibugi Livia, Korpela Taija, Cárdenas-Jaén Karina, de-Madaria Enrique, Capurso Gabriele

机构信息

Department of Gastroenterology, University Hospital Rijeka, Rijeka, Croatia.

Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy.

出版信息

United European Gastroenterol J. 2018 Oct;6(8):1206-1214. doi: 10.1177/2050640618781168. Epub 2018 May 31.

Abstract

BACKGROUND

Statins are perceived as potential etiological factors for acute pancreatitis (AP), but recent evidence suggests the opposite. Our aim was to evaluate the association between statin use and risk of AP in observational studies.

METHODS

Medline, Scopus, and Web of Science were searched for cohort (C) and case-control (CC) studies evaluating statins as intervention and AP as outcome. Pooled adjusted odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated.

RESULTS

Thirteen studies (seven CC, six C) with 34,899 AP patients and 5,377,894 controls were included. Prevalence of statin use was 9.8% among AP patients and 25% among controls. Pooled adjusted OR was 1.00 (95% CI = 0.63 to 1.59) with considerable heterogeneity ( = 98%). CC studies were associated with increased AP risk (OR = 1.33; 95% CI = 1.20 to 1.47), unlike C studies (OR = 0.69; 95% CI = 0.37 to 1.31). No association with increased risk was found for studies from Western countries (OR = 0.90; 95% CI = 0.52 to 1.56), unlike for studies conducted in Asia (OR = 1.39; 95% CI = 1.10 to 1.75).

CONCLUSION

Statin use is not associated with increased risk of AP. Increased risk was limited to CC studies, which are more prone to bias, while C studies showed no global effect. Further research is needed to clarify whether statin type, dosage, treatment duration or AP etiology might account for this difference.

摘要

背景

他汀类药物被认为是急性胰腺炎(AP)的潜在病因,但最近的证据表明情况恰恰相反。我们的目的是在观察性研究中评估他汀类药物的使用与AP风险之间的关联。

方法

检索Medline、Scopus和Web of Science数据库,查找将他汀类药物作为干预措施、AP作为结局的队列(C)研究和病例对照(CC)研究。计算合并调整比值比(OR)及相应的95%置信区间(CI)。

结果

纳入了13项研究(7项CC研究,6项C研究),涉及34899例AP患者和5377894例对照。AP患者中他汀类药物的使用率为9.8%,对照中为25%。合并调整OR为1.00(95%CI = 0.63至1.59),存在相当大的异质性(I² = 98%)。与C研究不同(OR = 0.69;95%CI = 0.37至1.31),CC研究与AP风险增加相关(OR = 1.33;95%CI = 1.20至1.47)。与亚洲进行的研究不同(OR = 1.39;95%CI = 1.10至1.75),西方国家的研究未发现与风险增加相关(OR = 0.90;95%CI = 0.52至1.56)。

结论

使用他汀类药物与AP风险增加无关。风险增加仅限于更易出现偏倚的CC研究,而C研究未显示总体影响。需要进一步研究以阐明他汀类药物的类型、剂量、治疗持续时间或AP病因是否可能解释这种差异。

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本文引用的文献

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Statins for the Prevention of Acute Pancreatitis.他汀类药物用于预防急性胰腺炎
Am J Gastroenterol. 2017 Dec;112(12):1765-1767. doi: 10.1038/ajg.2017.396. Epub 2017 Oct 31.
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Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States.美国胃肠道、肝脏和胰腺疾病负担
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