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使用他汀类药物与骨髓增生性肿瘤风险:一项丹麦全国范围内的病例对照研究。

Use of statins and risk of myeloproliferative neoplasms: a Danish nationwide case-control study.

机构信息

Department of Hematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark.

Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

出版信息

Blood Adv. 2023 Jul 25;7(14):3450-3457. doi: 10.1182/bloodadvances.2023009784.

Abstract

Previous studies have indicated a possible cancer-protective effect of statins in solid cancers; however, this has never been investigated in myeloproliferative neoplasms (MPNs). We aimed to investigate the association between statin use and the risk of MPNs in a nested nationwide case-control study, using Danish national population registries. Information on statin use was obtained from the Danish National Prescription Registry, and patients diagnosed with MPNs between 2010 and 2018 were identified from the Danish National Chronic Myeloid Neoplasia Registry. The association between statin use and MPNs was estimated using age- and sex-adjusted odds ratios (ORs) and fully adjusted ORs (aORs), adjusting for prespecified confounders. The study population included 3816 cases with MPNs and 19 080 population controls (5:1) matched for age and sex using incidence density sampling. Overall, 34.9% of the cases and 33.5% of the controls ever used statins, resulting in an OR for MPN of 1.07 (95% confidence interval [CI], 0.99-1.16) and an aOR of 0.87 (95% CI, 0.80-0.96), respectively. 17.2% were categorized as long-term users (≥5 years) among the cases compared with 19.0% among controls, yielding an OR for MPN of 0.90 (95% CI, 0.81-1.00) and an aOR of 0.72 (95% CI, 0.64-0.81). Analysis of the effect of the cumulative duration of statin use revealed a dose-dependent response, and the association was consistent for sex, age, and MPN subgroups and across different statin types. Statin users were associated with significantly lower odds of being diagnosed with an MPN, indicating a possible cancer-preventive effect of statins. The retrospective of this study precludes causal inferences.

摘要

先前的研究表明他汀类药物对实体瘤可能具有抗癌作用;然而,这在骨髓增生性肿瘤(MPN)中从未被研究过。我们旨在通过使用丹麦国家人口登记处进行嵌套式全国病例对照研究,调查他汀类药物使用与 MPN 风险之间的关系。他汀类药物使用信息来自丹麦国家处方登记处,并且从丹麦国家慢性髓系白血病登记处确定了 2010 年至 2018 年间诊断为 MPN 的患者。使用年龄和性别调整的优势比(OR)和完全调整的 OR(aOR)来估计他汀类药物使用与 MPN 之间的关联,同时调整了预先指定的混杂因素。该研究人群包括 3816 例 MPN 病例和 19080 例人口对照(5:1),使用发病率密度抽样按年龄和性别匹配。总体而言,34.9%的病例和 33.5%的对照者曾经使用过他汀类药物,导致 MPN 的 OR 为 1.07(95%CI,0.99-1.16),aOR 为 0.87(95%CI,0.80-0.96)。与对照者(19.0%)相比,病例中有 17.2%被归类为长期使用者(≥5 年),MPN 的 OR 为 0.90(95%CI,0.81-1.00),aOR 为 0.72(95%CI,0.64-0.81)。他汀类药物使用累积持续时间的分析结果表明存在剂量依赖性反应,并且这种关联在性别、年龄和 MPN 亚组以及不同的他汀类药物类型之间是一致的。他汀类药物使用者与 MPN 诊断的可能性较低相关,表明他汀类药物可能具有抗癌作用。这项研究的回顾性限制了因果推论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e63/10362262/bb79e73a5ba8/BLOODA_ADV-2023-009784-fx1.jpg

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