Wang Xinyue, Zhou Lijun, Wang Qiutao, Wu Min
Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
PLoS One. 2025 Jun 3;20(6):e0323210. doi: 10.1371/journal.pone.0323210. eCollection 2025.
Numerous lipid-lowering medications are commonly used in clinical settings; however, their impact on vascular endothelial function remains unclear. This study employed techniques like flow-mediated dilation (FMD) to demonstrate the relative effects of lipid-lowering medications on vascular function. PubMed, Embase, and World of Science were searched from January 1, 2011 to October 1, 2024, and the language was limited to English. Randomized controlled trials (RCTs) have assessed the impact of lipid-lowering medications versus placebos on FMD in individuals. The outcomes included FMD, pulse wave velocity (PWV), low-density lipoprotein cholesterol (LDL-C), peak O2 consumption (VO2), and intimal media thickness (IMT). We computed standardized mean differences and 95% confidence intervals (CIs). P < 0.05 indicates statistical significance. The quality of the RCTs was assessed according to the methods provided by the Cochrane Handbook, and effective data were extracted. Revman software 5.4 version was used for statistical analysis. Drug type, intervention duration, and underlying diseases were used as covariates in the subgroup analysis. This meta-analysis included 19 RCTs involving 1,004 patients. Compared with placebo, lipid-lowering agents significantly reduced FMD (0.20 [95% CI: 0.05, 0.35], P = 0.007, I2 = 43%, 14 trials, 726 participants), LDL-C (-1.54 [95% CI: -1.78, -1.30], P < 0.00001, I2 = 25%, 7 trials, 350 participants) and PWV (-0.35 [95% CI: -0.57, -0.02], P = 0.04, I2 = 0.0%, 4 trials, 206 participants). Lipid-lowering drugs positively affect endothelial function, while lowering blood lipids and statins are the most effective.
临床环境中常用多种降脂药物；然而，它们对血管内皮功能的影响仍不清楚。本研究采用诸如血流介导的血管舒张（FMD）等技术来证明降脂药物对血管功能的相对影响。检索了2011年1月1日至2024年10月1日期间的PubMed、Embase和科学在线，语言限于英语。随机对照试验（RCT）评估了降脂药物与安慰剂对个体FMD的影响。结局指标包括FMD、脉搏波速度（PWV）、低密度脂蛋白胆固醇（LDL-C）、峰值耗氧量（VO2）和内膜中层厚度（IMT）。我们计算了标准化均数差值和95%置信区间（CI）。P < 0.05表示具有统计学意义。根据Cochrane手册提供的方法评估RCT的质量，并提取有效数据。使用Revman软件5.4版本进行统计分析。在亚组分析中，将药物类型、干预持续时间和基础疾病用作协变量。这项荟萃分析纳入了19项涉及1004例患者的RCT。与安慰剂相比，降脂药物显著降低了FMD（0.20 [95% CI：0.05，0.35]，P = 0.007，I2 = 43%，14项试验，726名参与者）、LDL-C（-1.54 [95% CI：-1.78，-1.30]，P < 0.00001，I2 = 25%，7项试验，350名参与者）和PWV（-0.35 [95% CI：-0.57，-0.02]，P = 0.04，I2 = 0.0%，4项试验，206名参与者）。降脂药物对内皮功能有积极影响，而降脂药物中他汀类药物最为有效。
