The Effect of Statin Therapy on Bone Metabolism Markers and Mineral Density: Aa GRADE-Assessed Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials.
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引用次数: 0
Abstract
Purpose: 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.
Methods: PubMed/MEDLINE, Scopus, and Clarivate Analytics Web of Science databases were searched from inception to August 2023, using MESH terms and keywords.
Results: 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; P=0.03; I2=0%,), and bone mineral density (BMD) at different sites (WMD=-0.06 g/cm2; 95% CI -0.08 to -0.04; P<0.001; I2=97.7%, P<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.
Conclusion: 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.
目的:他汀类药物疗法被广泛用于治疗血脂异常和预防心血管疾病(CVDs)。然而,人们越来越关注他汀类药物对骨代谢指标和矿物质密度的潜在影响。本系统综述和荟萃分析旨在研究他汀类药物治疗对这些参数的影响:方法:使用 MESH 术语和关键词检索了 PubMed/MEDLINE、Scopus 和 Clarivate Analytics Web of Science 数据库,检索期从开始到 2023 年 8 月:结果:在筛选了2450篇文章后,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)被用于荟萃分析。研究结果表明,他汀类药物治疗可显著降低骨特异性碱性磷酸酶(B-ALP)水平(WMD=-1.1 U/L;95% CI -2.2 to -0.07;P=0.03;I2=0%)和不同部位的骨矿物质密度(BMD)(WMD=-0.06 g/cm2;95% CI -0.08 to -0.04;P2=97.7%;PC):本系统综述和荟萃分析提供的证据表明,他汀类药物治疗与 B-ALP 水平和骨骼不同部位 BMD 的显著降低有关。需要进一步研究他汀类药物治疗对骨骼健康的长期影响,并找出潜在的内在机制。