Department of Hematology and Blood Transfusion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Curr Pharm Des. 2024;30(20):1564-1577. doi: 10.2174/0113816128299493240403084905.
Some clinical trials have indicated the beneficial effects of statins in patients with kidney disease, while others have reported no positive effect of statins in these patients. We conducted this meta-analysis to identify the effects of statins on serum levels of interleukin-6 (IL-6) and Tumor Necrosis Factor Alpha (TNF-α) in patients with kidney disease.
A systematic literature search was performed using PubMed, Scopus, and Web of Science databases to identify all studies published from inception to August, 2022. The major outcome variable was the Weighted Mean Difference (WMD). Eligible studies were stratified based on target population, intervention duration, dosage and type of statins, and solubility of statins.
Meta-analysis performed on seven publications (8 studies), including 213 patients with kidney disease and 188 control individuals, indicated that the concentration of IL-6 was marginally decreased in patients with kidney disease following statin therapy disease (WMD = -1.15 pg/mL; 95% CI = -2.33 to 0.04, P = 0.05, I = 68.5%). The findings of subgroup analysis based on the dosage of statins showed that neither highintensity nor moderate/low-intensity statin treatment could significantly influence the serum level of IL-6. Lipophilic statins were more effective than hydrophilic statins, and they marginally decreased the levels of IL-6 (WMD = -1.21 pg/mL; 95% CI = -2.43 to 0, P = 0.05, I2 = 55.7%). Meta-analysis of four publications (five studies) with 157 patients with kidney disease and 132 control subjects showed that statins reduced the serum levels of TNF-α in patients with kidney disease when compared with control individuals (WMD= -2.66 pg/mL; 95% CI = -4.26 to -1.06, P < 0.001, I = 63%).
Statins only marginally decreased the concentration of IL-6 in patients with kidney disease, but neither high-intensity nor moderate/low-intensity statin treatment could significantly influence the level of IL-6. However, statins reduced serum levels of TNF-α in patients with kidney disease.
一些临床试验表明他汀类药物对肾病患者有益，而另一些临床试验则报告他汀类药物对这些患者没有积极作用。我们进行了这项荟萃分析，以确定他汀类药物对肾病患者血清白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平的影响。
使用 PubMed、Scopus 和 Web of Science 数据库进行系统文献检索，以确定截至 2022 年 8 月发表的所有研究。主要结局变量是加权均数差（WMD）。根据目标人群、干预持续时间、他汀类药物剂量和类型以及他汀类药物的溶解性对合格研究进行分层。
对 7 篇文献（8 项研究）进行荟萃分析，包括 213 例肾病患者和 188 例对照个体，结果表明，肾病患者接受他汀类药物治疗后，IL-6 浓度略有降低（WMD = -1.15 pg/mL；95% CI = -2.33 至 0.04，P = 0.05，I = 68.5%）。根据他汀类药物剂量进行的亚组分析结果表明，高强度和中/低强度他汀类药物治疗均不能显著影响 IL-6 血清水平。亲脂性他汀类药物比亲水性他汀类药物更有效，它们略微降低了 IL-6 的水平（WMD = -1.21 pg/mL；95% CI = -2.43 至 0，P = 0.05，I2 = 55.7%）。对 4 篇文献（5 项研究）进行荟萃分析，包括 157 例肾病患者和 132 例对照个体，结果表明，与对照组相比，他汀类药物降低了肾病患者的 TNF-α 血清水平（WMD= -2.66 pg/mL；95% CI = -4.26 至 -1.06，P < 0.001，I = 63%）。
他汀类药物仅略微降低了肾病患者的 IL-6 浓度，但高强度和中/低强度他汀类药物治疗均不能显著影响 IL-6 水平。然而，他汀类药物降低了肾病患者的 TNF-α 血清水平。
