非氮双膦酸盐和氮双膦酸盐治疗动脉粥样硬化和血管钙化：一项荟萃分析。

Non-nitrogen-containing bisphosphonates and nitrogen-containing bisphosphonates for the treatment of atherosclerosis and vascular calcification: A meta-analysis.

机构信息

Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.

Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China.

出版信息

Medicine (Baltimore). 2024 Jun 7;103(23):e38404. doi: 10.1097/MD.0000000000038404.

DOI:10.1097/MD.0000000000038404

PMID:38847712

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11155605/

Abstract

BACKGROUND

The role of non-nitrogen-containing bisphosphonates (non-N-BPs) and nitrogen-containing bisphosphonates (N-BPs) in the treatment of atherosclerosis (AS) and vascular calcification (VC) is uncertain. This meta-analysis was conducted to evaluate the efficacy of non-N-BPs and N-BPs in the treatment of AS and VC.

METHODS

The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched from their inception to July 5th, 2023. Eligible studies comparing bisphosphonates (BPs) versus no BPs in the treatment of AS and VC were included. The data were analyzed using Review Manager Version 5.3.

RESULTS

Seventeen studies were included in this meta-analysis. Twelve were randomized control trials (RCTs), and 5 were nonrandomized studies. Overall, 813 patients were included in the BPs group, and 821 patients were included in the no BPs group. Compared with no BP treatment, non-N-BP or N-BP treatment did not affect serum calcium (P > .05), phosphorus (P > .05) or parathyroid hormone (PTH) levels (P > .05). Regarding the effect on serum lipids, non-N-BPs decreased the serum total cholesterol (TC) level (P < .05) and increased the serum triglyceride (TG) level (P < .01) but did not affect the serum low-density lipoprotein cholesterol (LDL-C) level (P > .05). N-BPs did not affect serum TC (P > .05), TG (P > .05) or LDL-C levels (P > .05). Regarding the effect on AS, non-N-BPs did not have a beneficial effect (P > .05). N-BPs had a beneficial effect on AS, including reducing the intima-media thickness (IMT) (P < .05) and plaque area (P < .01). For the effect on VC, non-N-BPs had a beneficial effect (P < .01), but N-BPs did not have a beneficial effect (P > .05).

CONCLUSION

Non-N-BPs and N-BPs did not affect serum calcium, phosphorus or PTH levels. Non-N-BPs decreased serum TC levels and increased serum TG levels. N-BPs did not affect serum lipid levels. Non-N-BPs had a beneficial effect on VC, and N-BPs had a beneficial effect on AS.

摘要

背景

非氮双膦酸盐（non-N-BPs）和氮双膦酸盐（N-BPs）在治疗动脉粥样硬化（AS）和血管钙化（VC）中的作用尚不确定。本荟萃分析旨在评估 non-N-BPs 和 N-BPs 在治疗 AS 和 VC 中的疗效。

方法

检索 PubMed、Embase、Cochrane 图书馆、中国知网和万方数据库，检索时间均从建库至 2023 年 7 月 5 日。纳入比较双膦酸盐（BPs）与非 BPs 治疗 AS 和 VC 的研究。使用 Review Manager Version 5.3 对数据进行分析。

结果

本荟萃分析纳入 17 项研究。其中 12 项为随机对照试验（RCTs），5 项为非随机研究。共有 813 例患者纳入 BPs 组，821 例患者纳入非 BPs 组。与非 BP 治疗相比，非 N-BP 或 N-BP 治疗对血清钙（P＞.05）、磷（P＞.05）或甲状旁腺激素（PTH）水平（P＞.05）无影响。在血脂方面，非 N-BPs 降低了血清总胆固醇（TC）水平（P＜.05），升高了血清甘油三酯（TG）水平（P＜.01），但对血清低密度脂蛋白胆固醇（LDL-C）水平无影响（P＞.05）。N-BPs 对血清 TC（P＞.05）、TG（P＞.05）或 LDL-C 水平（P＞.05）无影响。在 AS 方面，非 N-BPs 无获益（P＞.05）。N-BPs 对 AS 有获益，包括降低内膜中层厚度（IMT）（P＜.05）和斑块面积（P＜.01）。在 VC 方面，非 N-BPs 有获益（P＜.01），但 N-BPs 无获益（P＞.05）。