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他汀类药物与肌萎缩侧索硬化症风险:系统评价和荟萃分析。

Statins and risk of amyotrophic lateral sclerosis: a systematic review and meta-analysis.

机构信息

Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.

Student's Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Acta Neurol Belg. 2022 Aug;122(4):979-986. doi: 10.1007/s13760-021-01753-8. Epub 2021 Jul 28.

Abstract

Amyotrophic lateral sclerosis (ALS) is a paralytic, heterogeneous and progressive disease characterized by the degeneration of both upper and lower motor neurons. Several studies about the effects of statins drug on the risk of ALS showed contradictory results and evidence for this is inconclusive. So we aimed to perform a meta-analysis on previous studies to clarify the association between statin use and risk of ALS. The databases including PubMed, Scopus, and Web of science were searched in February 2021 for studies that reported the association between statin use and risk of ALS. The eligible studies had to provide a report on the effect of statin and the incidence of ALS while comparing it to the control group. Articles that had low statin exposure time, the absence of a control group and an unknown number of ALS patients were excluded. The rate ratio and 95% confidence interval (CI) were used for association measures in case-control and cohort studies. After full-text and abstract review, data from 8 studies with a total of 547,622 participants and 13,890 cases of ALS were entered in the present meta-analysis. We combined eight studies using a random-effect model and the RR for statin users among groups was 0.98 (95% CI 0.80-1.20) which indicates no association between statin and incidence of ALS. Also high heterogeneity was detected across the studies (Q value = 26.62, P = .00; I = 72.71%). In our meta-analysis study, we found no association between statin use and an increase in ALS incidence. This result is in line with some previous studies and provides strong evidence that denies the possible association between statin uptake and disease induction.

摘要

肌萎缩侧索硬化症(ALS)是一种麻痹性、异质性和进行性疾病,其特征是上下运动神经元的退化。一些关于他汀类药物对 ALS 风险影响的研究结果显示出相互矛盾的结果,并且证据尚无定论。因此,我们旨在对以往的研究进行荟萃分析,以阐明他汀类药物的使用与 ALS 风险之间的关联。我们于 2021 年 2 月在 PubMed、Scopus 和 Web of Science 数据库中搜索了报告他汀类药物使用与 ALS 风险之间关联的研究。合格的研究必须提供关于他汀类药物的效果和 ALS 发生率的报告,同时将其与对照组进行比较。排除他汀类药物暴露时间短、缺乏对照组和 ALS 患者数量未知的文章。病例对照研究和队列研究中使用率比和 95%置信区间(CI)来衡量关联。在全文和摘要审查后,有 8 项研究共 547622 名参与者和 13890 例 ALS 病例的数据纳入本荟萃分析。我们使用随机效应模型对 8 项研究进行了合并,他汀类药物使用者的 RR 为 0.98(95%CI 0.80-1.20),这表明他汀类药物与 ALS 发生率之间没有关联。此外,研究之间还存在高度异质性(Q 值=26.62,P=0.00;I=72.71%)。在我们的荟萃分析研究中,我们没有发现他汀类药物使用与 ALS 发病率增加之间存在关联。这一结果与一些先前的研究一致,并提供了强有力的证据,否定了他汀类药物摄入与疾病诱导之间可能存在的关联。

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