Sabeel Solima, Motaung Bongani, Nguyen Kim A, Ozturk Mumin, Mukasa Sandra L, Wolmarans Karen, Blom Dirk J, Sliwa Karen, Nepolo Emmanuel, Günther Gunar, Wilkinson Robert J, Schacht Claudia, Kengne Andre Pascal, Thienemann Friedrich, Guler Reto
Institute of Infectious Diseases and Molecular Medicine (IDM), Department of Pathology, Division of Immunology, Faculty of Health Sciences, University of Cape Town, South Africa.
International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, South Africa.
PLoS One. 2025 May 29;20(5):e0323749. doi: 10.1371/journal.pone.0323749. eCollection 2025.
While numerous studies have extensively documented the pleiotropic effects of statins, including their capacity to reduce inflammation, there is a lack of research estimating the anti-inflammatory effectiveness of statins among individuals with chronic diseases. This meta-analysis evaluates the effect of statin therapy on inflammatory markers and the lipid profile in patients with chronic diseases by analysing evidence from randomized controlled trials (RCTs). We conducted a systematic review and searched articles published between 1st January 1999 and 31st December 2023 in databases including PubMed, Web of Science, Scopus, and Cochrane. The meta-analysis was performed using random effects models and inverse variance. Effect measures were mean differences (MD) and 95% confidence intervals (CI). Collectively, statins significantly reduced IL-6 (MD = -0.24 ng/dL [95% CI, -0.36 to -0.13], I2 = 98.3%, p < 0.001), TNF-α (MD = -0.74 ng/dL [95% CI, -1.08 to -0.40], I2 = 98.8%, p < 0.001); and CRP (MD = -1.58 mg/L [95% CI, -2.22 to -0.94], I2 = 86.5%, p < 0.001). Notably, atorvastatin demonstrated the most significant reduction in IL-6 and TNF-α levels, while fluvastatin and rosuvastatin displayed the greatest impact on decreasing CRP and LDL-C levels, respectively. Stratification by a longer treatment duration of more than four months revealed that atorvastatin achieved the most significant reduction in IL-6 and TNF-α. In conclusion, statin therapy not only regulates the lipid profile but also reduces systemic inflammatory biomarkers. Prolonged administration of statins led to a more substantial reduction in IL-6 and TNF-α, with atorvastatin exhibiting the greatest effect in our analysis.
虽然众多研究广泛记录了他汀类药物的多效性作用，包括其减轻炎症的能力，但缺乏关于慢性疾病患者中他汀类药物抗炎效果的研究。这项荟萃分析通过分析随机对照试验（RCT）的证据，评估他汀类药物治疗对慢性疾病患者炎症标志物和血脂谱的影响。我们进行了一项系统综述，并检索了1999年1月1日至2023年12月31日期间在包括PubMed、科学网、Scopus和Cochrane等数据库中发表的文章。荟萃分析采用随机效应模型和逆方差法进行。效应量为均值差（MD）和95%置信区间（CI）。总体而言，他汀类药物显著降低了白细胞介素-6（IL-6）（MD = -0.24 ng/dL [95% CI，-0.36至-0.13]，I2 = 98.3%，p < 0.001）、肿瘤坏死因子-α（TNF-α）（MD = -0.74 ng/dL [95% CI，-1.08至-0.40]，I2 = 98.8%，p < 0.001）；以及C反应蛋白（CRP）（MD = -1.58 mg/L [95% CI，-2.22至-0.94]，I2 = 86.5%，p < 0.001）。值得注意的是，阿托伐他汀在降低IL-6和TNF-α水平方面表现出最显著的效果，而氟伐他汀和瑞舒伐他汀分别对降低CRP和低密度脂蛋白胆固醇（LDL-C）水平产生了最大影响。按治疗时间超过四个月进行分层分析显示，阿托伐他汀在降低IL-6和TNF-α方面效果最为显著。总之，他汀类药物治疗不仅能调节血脂谱，还能降低全身炎症生物标志物水平。长期服用他汀类药物可更显著地降低IL-6和TNF-α水平，在我们的分析中，阿托伐他汀的效果最为显著。
