β-地中海贫血患者的血脂谱异常：系统评价和荟萃分析。
Serum lipid profile abnormalities among beta-thalassemia patients: a systematic review and meta-analysis.
机构信息
Faculty of Medicine, University of Khartoum, P.O. Box 302, Khartoum, Sudan.
Harlem Hospital Center, New York, NY, US.
出版信息
Lipids Health Dis. 2024 Nov 25;23(1):388. doi: 10.1186/s12944-024-02377-6.
BACKGROUND
Patients with betathalassemia have higher risk of various metabolic disturbances. The literature presents conflicting results about the patterns of abnormal lipid profile among patients with betathalassemia. This systematic review aimed to assess dyslipidemia patterns among patients with betathalassemia when compared with healthy individuals.
METHODS
The methods used were adherent to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Systematic searches of the literature were done across Medline/PubMed, Web of Science, Science Direct, and Regional Portal of the World Health Organization Virtual Health Library. Calculation of standardized mean difference (SMD) estimates and their associated 95% confidence intervals (CIs) were done through Jamovi software.
RESULTS
The systematic review included 21 studies meeting the criteria for the analyses. Patients with beta-thalassemia major displayed significantly elevated triglyceride levels (SMD: 0.448, 95% CI, 0.214 to 0.682; P < .001) and reduced total serum cholesterol (SMD: -2.26 (95% CI-2.834 to -1.678; P < .001), as well as decreased levels of both low-density lipoprotein cholesterol (SMD: -1.88, 95% CI, -2.614 to -1.147; P < .001) and high-density lipoprotein cholesterol (SMD: -1.32, 95% CI, -1.786 to -0.860; P < .001). Similarly, beta-thalassemia intermedia patients exhibited comparable lipid profile abnormalities to those with beta-thalassemia major. Conversely, beta-thalassemia minor patients only showed significantly lower total serum cholesterol levels (SMD: -0.66, 95% CI, -0.860 to -0.472; P < .001).
CONCLUSION
Evidence indicates alterations in lipid profile markers among beta-thalassemia patients. The findings indicate the importance of assessing hypertriglyceridemia and hypocholesterolemia in these patients, especially those with major and intermedia forms, as these lipid profile abnormalities increase the risk of cardiovascular disease.
背景
患有β地中海贫血症的患者有更高的发生各种代谢紊乱的风险。关于β地中海贫血症患者脂质谱异常的模式，文献中存在相互矛盾的结果。本系统评价旨在评估与健康个体相比，β地中海贫血症患者的血脂异常模式。
方法
所使用的方法符合系统评价和荟萃分析的首选报告项目（PRISMA）指南。对 Medline/PubMed、Web of Science、Science Direct 和世界卫生组织虚拟卫生图书馆区域门户进行了系统的文献搜索。通过 Jamovi 软件计算标准化均数差值（SMD）估计值及其相关的 95%置信区间（CI）。
结果
系统评价纳入了符合分析标准的 21 项研究。重型β地中海贫血症患者的甘油三酯水平显著升高（SMD：0.448，95%CI：0.214 至 0.682；P<0.001），总血清胆固醇水平降低（SMD：-2.26（95%CI：-2.834 至-1.678；P<0.001），以及低密度脂蛋白胆固醇（SMD：-1.88，95%CI：-2.614 至-1.147；P<0.001）和高密度脂蛋白胆固醇（SMD：-1.32，95%CI：-1.786 至-0.860；P<0.001）水平降低。同样，中间型β地中海贫血症患者的脂质谱异常与重型β地中海贫血症患者相似。相反，轻型β地中海贫血症患者仅表现出总血清胆固醇水平显著降低（SMD：-0.66，95%CI：-0.860 至-0.472；P<0.001）。
结论
证据表明β地中海贫血症患者的脂质谱标志物发生了变化。这些发现表明，评估这些患者的高甘油三酯血症和低胆固醇血症很重要，特别是那些患有重型和中间型的患者，因为这些脂质谱异常会增加患心血管疾病的风险。
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