University of British Columbia (UBC) Department of Anesthesiology, Pharmacology & Therapeutics, Vancouver, Canada.
UBC Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada.
J Neuromuscul Dis. 2023;10(4):505-516. doi: 10.3233/JND-230064.
Muscular dystrophies (MDs) are characterized by chronic muscle wasting but also poorly understood metabolic co-morbidities. We have recently shown that Duchenne MD (DMD) patients, dogs and asymptomatic carriers are affected by a new form of dyslipidemia that may exacerbate muscle damage.
We aimed to perform a systematic review and meta-analysis for evidence that other types of MDs are associated with dyslipidemia compared to healthy controls.
Search was conducted using MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials for reports that compare plasma/serum lipids from MD patients and controls, and meta-analysis of cross-sectional studies quantifying total cholesterol, high-density lipoprotein, low density lipoprotein and triglycerides was performed.
Out of 749 studies, 17 met our inclusion criteria for meta-analysis. 14 of the 17 studies (82%) included investigated myotonic dystrophy (DM); other studies were on pseudohypertrophic MD (PMD) or DMD. As a whole, MD individuals had significantly higher levels of circulating total cholesterol (Hedges' g with 95% confidence interval [CI], 0.80 [0.03 - 1.56]; p = 0.04) and triglycerides (Hedges' g with 95% confidence interval [CI], 2.28[0.63 - 3.92]; p = 0.01) compared to controls. Meta-regression analysis showed the percentage of male gender was significantly associated with the difference in total cholesterol (beta = 0.05; 95% CI, - 0.02 to 0.11; p = 0.043) and high-density lipoprotein (beta = - 9.38; 95% CI, - 16.26 to - 2.50; p = 0.028).
MD is associated with significantly higher circulating levels of total cholesterol and triglycerides. However, caution on the interpretation of these findings is warranted and future longitudinal research is required to better understand this relationship.
肌肉萎缩症（MDs）的特征是慢性肌肉消耗，但也存在代谢合并症，这些合并症尚未得到充分认识。我们最近发现，杜氏肌营养不良症（DMD）患者、狗和无症状携带者受到一种新形式的血脂异常的影响，这种血脂异常可能会加重肌肉损伤。
我们旨在进行系统评价和荟萃分析，以评估与健康对照组相比，其他类型的 MD 是否与血脂异常有关。
使用 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库搜索报告，比较 MD 患者和对照组的血浆/血清脂质，并对定量总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯的横断面研究进行荟萃分析。
在 749 项研究中，有 17 项符合荟萃分析的纳入标准。17 项研究中有 14 项（82%）研究了肌强直性营养不良（DM）；其他研究是关于假性肥大性 MD（PMD）或 DMD。总体而言，MD 个体的循环总胆固醇水平明显升高（95%置信区间的 Hedge's g，0.80[0.03-1.56]；p=0.04）和甘油三酯（Hedge's g 95%置信区间 [CI]，2.28[0.63-3.92]；p=0.01）比对照组高。元回归分析显示，男性比例与总胆固醇差异显著相关（beta=0.05；95%CI，-0.02 至 0.11；p=0.043）和高密度脂蛋白（beta=-9.38；95%CI，-16.26 至-2.50；p=0.028）。
MD 与总胆固醇和甘油三酯循环水平明显升高有关。然而，需要谨慎解释这些发现，需要进一步的纵向研究来更好地了解这种关系。
