Makris Anastasios, Pagkali Antonia, Nikolousis Emmanouil, Filippatos Theodosios D, Agouridis Aris P
School of Medicine, European University Cyprus, Nicosia, Cyprus.
School of Medicine, National and Kapodistrian University of Athens, Greece.
Atheroscler Plus. 2023 Sep 21;54:7-13. doi: 10.1016/j.athplu.2023.09.003. eCollection 2023 Dec.
To systematically investigate all relevant evidence on the association between high-density lipoprotein cholesterol (HDL-C) and multiple myeloma (MM).
We searched PubMed and Cochrane library databases (up to 20 September 2022) for studies with evidence on HDL-C in patients with MM. A qualitative synthesis of published prospective and retrospective studies for the role of HDL-C and other lipid profile parameters in MM was performed. Additionally, a meta-analysis on HDL-C mean differences (MD) between MM cases and controls was performed.
Fourteen studies (3 prospective, 11 retrospective) including 895 MM patients were eligible for this systematic review. Ten studies compared HDL-C levels in MM patients with healthy controls. In these 10 studies (n = 17,213), pooled analyses showed that MM patients had significantly lower HDL-C levels compared to healthy controls (MD: -13.07 mg/dl, 95% CI: -17.83, -8.32, p < 0.00001). Regarding secondary endpoints, total cholesterol (TC) (MD: -22.19 mg/dl, 95% CI: -39.08, -5.30) and apolipoprotein A-I (apoA-I) (-40.20 mg/dl, 95% CI: -55.00, -25.39) demonstrated significant decreases, while differences in low-density lipoprotein cholesterol (LDL-C) (MD: -11.33 mg/dl, 95% CI: -36.95, 14.30) and triglycerides (MD: 9.93 mg/dl, 95% CI: -3.40, 23.26) were not shown to be significant.
HDL-C, as well as TC and apoA-I, levels are significantly decreased in MM. Hence, lipid profile parameters should be taken into account when assessing such patients.
系统研究高密度脂蛋白胆固醇（HDL-C）与多发性骨髓瘤（MM）之间关联的所有相关证据。
我们检索了PubMed和Cochrane图书馆数据库（截至2022年9月20日），以查找有关MM患者HDL-C证据的研究。对已发表的关于HDL-C及其他血脂谱参数在MM中的作用的前瞻性和回顾性研究进行了定性综合分析。此外，对MM病例与对照之间的HDL-C平均差异（MD）进行了荟萃分析。
14项研究（3项前瞻性研究，11项回顾性研究），包括895例MM患者，符合本系统评价的标准。10项研究比较了MM患者与健康对照的HDL-C水平。在这10项研究（n = 17,213）中，汇总分析显示，与健康对照相比，MM患者的HDL-C水平显著降低（MD：-13.07mg/dl，95%CI：-17.83，-8.32，p < 0.00001）。关于次要终点，总胆固醇（TC）（MD：-22.19mg/dl，95%CI：-39.08，-5.30）和载脂蛋白A-I（apoA-I）（-40.20mg/dl，95%CI：-55.00，-25.39）显示出显著降低，而低密度脂蛋白胆固醇（LDL-C）（MD：-11.33mg/dl，95%CI：-36.95，14.30）和甘油三酯（MD：9.93mg/dl，95%CI：-3.40，23.26）的差异未显示出显著性。
MM患者的HDL-C以及TC和apoA-I水平显著降低。因此，在评估此类患者时应考虑血脂谱参数。
