Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Clin Neurosci. 2021 Dec;94:216-225. doi: 10.1016/j.jocn.2021.10.032. Epub 2021 Nov 5.
Previous studies have shown that low serum lipids and statins may be related to cerebral hemorrhage. We made the meta-analysis to evaluate the associations between serum lipid levels or statins treatment and cerebral microbleeds (CMBs) to identify whether the similar correlation also existed.
We comprehensively searched the Medline, Embase, Cochrane library, Web of Science, only included English journal articles, and systematically collected the observational studies and randomized controlled trials (RCTs) from September 1975 to August 2021. Random-effects model was used to pool data. Statistical heterogeneity was assessed by I statistic and chi-square. 11 items checklists recommended by the Agency for Healthcare Research and Quality (AHRQ), Newcastle-Ottawa Scale (NOS), and Cochrane Risk of Bias tool (ROB) were used to evaluate the methodological quality of cross-sectional studies, cohort studies and randomized controlled trial, respectively.
Five cohort studies, two RCTs, and ten cross-sectional studies, including 16,637 subjects and 2663 CMBs patients, were included in our quantitative synthesis. Our study found that after adjusting the covariates, total cholesterol (TC) was significantly inversely correlated with the prevalent CMBs in any location, while total triglycerides (TG) and High-density lipoprotein (HDL) were significantly inversely associated with prevalent deep CMBs. Low-density lipoprotein (LDL) was negatively associated with incident CMBs after adjusted confounders. We did not found statistical differences between statin and CMBs after adjusted covariates.
Serum major lipid (TC TG HDL LDL) levels may be inversely associated with CMBs. Currently, no sufficient evidence proves that statin therapy is the risk factor of CMBs.
先前的研究表明，血清脂质水平较低和使用他汀类药物可能与脑出血有关。我们进行了荟萃分析，以评估血清脂质水平或他汀类药物治疗与脑微出血（CMBs）之间的关联，以确定是否存在类似的相关性。
我们全面检索了 Medline、Embase、Cochrane 图书馆、Web of Science，仅纳入英文期刊文章，并系统地收集了 1975 年 9 月至 2021 年 8 月的观察性研究和随机对照试验（RCTs）。使用随机效应模型汇总数据。通过 I 统计量和卡方评估数据的异质性。使用 Agency for Healthcare Research and Quality（AHRQ）、Newcastle-Ottawa Scale（NOS）和 Cochrane 偏倚风险工具（ROB）推荐的 11 项清单分别评估横断面研究、队列研究和随机对照试验的方法学质量。
纳入了五项队列研究、两项 RCT 和十项横断面研究，共纳入 16637 名受试者和 2663 名 CMB 患者。我们的研究发现，在调整协变量后，总胆固醇（TC）与任何部位的 CMB 患病率呈显著负相关，而总甘油三酯（TG）和高密度脂蛋白（HDL）与深部 CMB 的患病率呈显著负相关。调整混杂因素后，低密度脂蛋白（LDL）与 CMB 的发生率呈负相关。在调整混杂因素后，我们没有发现他汀类药物与 CMBs 之间存在统计学差异。
血清主要脂质（TC、TG、HDL、LDL）水平可能与 CMBs 呈负相关。目前，没有足够的证据表明他汀类药物治疗是 CMBs 的危险因素。
