Lee Bora, Jung Eun-Ae, Yoo Jeong-Ju, Kim Sang Gyune, Lee Cheon-Beom, Kim Young Seok, Jeong Soung Won, Jang Jae Young, Lee Sae Hwan, Kim Hong Soo, Jun Baek Gyu, Kim Young Don, Cheon Gab Jin
Department of Statistics, Graduate School of Chung-Ang University, Seoul, Republic of Korea.
Medical Library, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Liver Int. 2020 Jun;40(6):1344-1355. doi: 10.1111/liv.14434. Epub 2020 Apr 7.
BACKGROUND & AIMS: Tamoxifen is associated with an increased risk of developing fatty liver. The aim of this systematic review and meta-analysis was to evaluate the prevalence and incidence of fatty liver developed after tamoxifen treatment in breast cancer patients.
A systematic search of PubMed (Medline), EMBASE, OVID Medline, the Cochrane Library and other databases was performed for this review. The abstracts obtained from the search were reviewed by two investigators who chose manuscripts for full-text review. The event rates were calculated with a random-effects model and quality-effects model.
The search yielded 165 references. Of these, 24 were included in the quantitative summary. We analysed the data of a total of 6,962 patients treated with tamoxifen and 975 patients not treated with tamoxifen. The prevalence of fatty liver among patients with breast cancer taking tamoxifen was 40.25 per 100 patients and the incidence rate was 12.37 per 100 person-years. The incidence of fatty liver was much higher in the tamoxifen group than in the control group [incidence rate ratio: 3.12, 95% CI (confidence interval): 2.05-4.75, I = 61%], regardless of region. The main risk factors were body mass index (BMI) [hazard ratio (HR): 1.15, 95% CI: 1.09-1.22] and hypercholesterolaemia (HR: 1.01, 95% CI: 1.00-1.02).
The use of tamoxifen was associated with increased risks in the incidence and prevalence of fatty liver, especially in patients with high BMI and hypercholesterolaemia.
他莫昔芬与脂肪肝发生风险增加相关。本系统评价和荟萃分析旨在评估乳腺癌患者接受他莫昔芬治疗后脂肪肝的患病率和发病率。
本评价对PubMed（Medline）、EMBASE、OVID Medline、Cochrane图书馆及其他数据库进行了系统检索。检索获得的摘要由两名研究者进行审查，他们选择手稿进行全文审查。采用随机效应模型和质量效应模型计算事件发生率。
检索共得到165篇参考文献。其中，24篇纳入定量汇总分析。我们分析了总共6962例接受他莫昔芬治疗的患者和975例未接受他莫昔芬治疗的患者的数据。服用他莫昔芬的乳腺癌患者中脂肪肝的患病率为每100例患者40.25例，发病率为每100人年12.37例。无论地区如何，他莫昔芬组的脂肪肝发病率均显著高于对照组[发病率比值：3.12，95%可信区间（CI）：2.05 - 4.75，I² = 61%]。主要危险因素为体重指数（BMI）[风险比（HR）：1.15，95%CI：1.09 - 1.22]和高胆固醇血症（HR：1.01，95%CI：1.00 - 1.02）。
使用他莫昔芬与脂肪肝发病率和患病率增加相关，尤其是在BMI高和患有高胆固醇血症的患者中。
