Analysis of vitamin D levels in patients with and without statin-associated myalgia - A systematic review and meta-analysis of 7 studies with 2420 patients

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:178

Article

Michalska-Kasiczak, Marta¹  Sahebkar, Amirhossein^2,3  Mikhailidis, Dimitri P.⁴  Rysz, Jacek⁵  Muntner, Paul⁶  Toth, Peter P.^7,8  Jones, Steven R.⁸  Rizzo, Manfredi⁹  Hovingh, G. Kees¹⁰  Farnier, Michel¹¹  Moriarty, Patrick M.^12,13  Bittner, Vera A.¹⁴  Lip, Gregory Y. H.¹⁵  Banach, Maciej¹ 

[1] Med Univ Lodz, Chair Nephrol & Hypertens, Dept Hypertens, PL-90549 Lodz, Poland

[2] Mashhad Univ, Med Sci, Biotechnol Res Ctr, Mashhad, Iran

[3] Univ Western Australia, Sch Med & Pharmacol, Royal Perth Hosp, Metab Res Ctr, Perth, WA 6009, Australia

[4] UCL, Sch Med, Dept Clin Biochem, London W1N 8AA, England

[5] Med Univ Lodz, Chair Nephrol & Hypertens, Dept Nephrol Hypertens & Family Med, PL-90549 Lodz, Poland

[6] Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA

[7] CGH Med Ctr, Sterling, IL USA

[8] Johns Hopkins Ciccarone Ctr Prevent Heart Dis, Baltimore, MD USA

[9] Univ Palermo, Biomed Dept Internal Med & Med Specialties, I-90133 Palermo, Italy

[10] Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1105 AZ Amsterdam, Netherlands

[11] Point Med, Dept Lipidol, Dijon, France

[12] Univ Kansas, Med Ctr, Sch Pharm, Dept Med, Kansas City, KS USA

[13] Univ Kansas, Med Ctr, Sch Med, Kansas City, KS USA

[14] Univ Alabama Birmingham, Prevent Cardiol Sect, Div Cardiovasc Dis, Birmingham, AL USA

[15] Univ Birmingham, City Hosp, Ctr Cardiovasc Sci, Birmingham, W Midlands, England

关键词: Myalgia;    Statin-associated myalgia;    Statin intolerance;    Vitamin D;   

DOI  :  10.1016/j.ijcard.2014.10.118

来源: Elsevier

【 摘 要 】

Introduction: Vitamin D (vit D) deficiency may be associated with an increased risk of statin-related symptomatic myalgia in statin-treated patients. The aim of this meta-analysis was to substantiate the role of serum vitamin D levels in statin-associated myalgia. Methods: The search included PUBMED, Cochrane Library, Scopus, and EMBASE from January 1, 1987 to April 1, 2014 to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. Two independent reviewers extracted data on study characteristics, methods and outcomes. Quantitative data synthesis was performed using a fixed-effect model. Results: The electronic search yielded 437 articles; of those 20 were scrutinized as full texts and 13 studies were considered unsuitable. The final analysis included 7 studies with 2420 statin-treated patients divided into subgroups of patients with (n = 666 [27.5%]) or without (n = 1754) myalgia. Plasma vit D concentrations in the symptomatic and asymptomatic subgroups were 28.4 +/- 13.80 ng/mL and 34.86 +/- 11.63 ng/mL, respectively. The combination of data fromindividual observational studies showed that vit D plasma concentrations were significantly lower in patients with statin-associated myalgia compared with patients not manifesting this side effect (weighted mean difference -9.41 ng/mL; 95% confidence interval: -10.17 to -8.64; p < 0.00001). Conclusions: This meta-analysis provides evidence that low vit D levels are associated with myalgia in patients on statin therapy. Randomized controlled trials are necessary to establish whether vitamin D supplementation reduces the risk for statin-associated myalgia. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free