Arabi Seyyed Mostafa, Chambari Mahla, Bahrami Leila Sadat, Jafari Ali, Bahari Hossein, Reiner Željko, Sahebkar Amirhossein
Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran.
Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran.
Adv Pharm Bull. 2024 Oct;14(3):591-603. doi: 10.34172/apb.2024.051. Epub 2024 Jun 22.
Statin therapy is widely used for the management of dyslipidemia and the prevention of cardiovascular diseases (CVDs). However, there is a growing concern about its potential effects on bone metabolism markers and mineral density. The aim of this systematic review and meta-analysis was to investigate the effect of statin therapy on these parameters.
PubMed/MEDLINE, Scopus, and Clarivate Analytics Web of Science databases were searched from inception to August 2023, using MESH terms and keywords.
After screening 2450 articles, 16 studies that met the inclusion criteria were included, of which 12 randomized controlled trials (RCTs) were used for meta-analysis. The findings showed that statin therapy significantly reduced bone-specific alkaline phosphatase (B-ALP) levels (WMD=-1.1 U/L; 95% CI -2.2 to -0.07; =0.03; I=0%,), and bone mineral density (BMD) at different sites (WMD=-0.06 g/cm; 95% CI -0.08 to -0.04; <0.001; I=97.7%, <0.001). However, this treatment did not have a significant effect on osteocalcin, serum C-terminal peptide of type I collagen (S-CTx), serum N-telopeptides of type I collagen (NTx) concentration, or overall fracture risk.
This systematic review and meta-analysis provide evidence that statin therapy is associated with a significant reduction in B-ALP levels and BMD at different sites of the skeleton. Further studies are needed to investigate the long-term effects of statin therapy on bone health and to identify the potential underlying mechanisms.
他汀类药物疗法广泛用于血脂异常的管理及心血管疾病（CVD）的预防。然而，其对骨代谢标志物和骨密度的潜在影响日益受到关注。本系统评价和荟萃分析的目的是研究他汀类药物疗法对这些参数的影响。
从数据库建库至2023年8月，使用医学主题词（MESH）和关键词在PubMed/MEDLINE、Scopus及科睿唯安Web of Science数据库中进行检索。
在筛选的2450篇文章中，纳入了16项符合纳入标准的研究，其中12项随机对照试验（RCT）用于荟萃分析。结果显示，他汀类药物疗法显著降低了骨特异性碱性磷酸酶（B-ALP）水平（加权均数差[WMD]=-1.1 U/L；95%置信区间[CI]为-2.2至-0.07；P=0.03；I²=0%），以及不同部位的骨密度（BMD）（WMD=-0.06 g/cm²；95% CI为-0.08至-0.04；P<0.001；I²=97.7%，P<0.001）。然而，该治疗对骨钙素、I型胶原血清C端肽（S-CTx）、I型胶原血清N端肽（NTx）浓度或总体骨折风险无显著影响。
本系统评价和荟萃分析提供的证据表明，他汀类药物疗法与骨骼不同部位的B-ALP水平和BMD显著降低有关。需要进一步研究来调查他汀类药物疗法对骨骼健康的长期影响，并确定潜在的机制。
