Background

Myopathy is the most widely reported statin-associated adverse event. Several studies have linked vitamin D deficiency with statin-related myopathy.

Objective

This meta-analysis aimed to investigate whether adult patients with statin-related myopathy have a lower 25-hydroxyvitamin D (25OHD) level than patients without myopathy and whether statin-related myopathy in vitamin D-deficient patients can be improved by vitamin D supplementation.

Methods

PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until 28 September 2020. Original studies comparing the 25OHD levels of patients with and without myopathy or detecting the impact of vitamin D supplementation on statin-related muscular intolerance were included. Subgroup analyses based on the sample size and baseline 25OHD level were conducted.

Results

This meta-analysis, based on nine cohort studies with a total of 2906 patients, revealed that the 25OHD level of patients with statin-related myopathy was significantly lower than that of patients without myopathy [weighted mean difference − 4.17 ng/mL; 95% confidence interval (CI) − 7.70 to − 0.63; p = 0.021]. The overall analysis from another four studies with 446 patients who were previously vitamin D deficient and reported statin-related muscular intolerance showed that the pooled tolerance rate of statins improved to 89% (95% CI 8692; p < 0.001) after vitamin D supplementation.

Conclusions

The present meta-analysis provides evidence that low 25OHD level is associated with statin-related myopathy and that exogenous vitamin D supplementation can improve statin-related muscular intolerance associated with low 25OHD level in most cases. Our findings may provide useful insight for the prevention and treatment of statin-related myopathy.

中文翻译：

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维生素 D 与他汀类药物相关肌病之间的关联：一项荟萃分析

背景

肌病是最广泛报道的他汀类药物相关不良事件。几项研究已将维生素 D 缺乏症与他汀类药物相关的肌病联系起来。

客观的

这项荟萃分析旨在调查患有他汀类药物相关肌病的成年患者的 25-羟基维生素 D (25OHD) 水平是否低于没有肌病的患者，以及维生素 D 缺乏症患者的他汀类药物相关肌病是否可以通过补充维生素 D 得到改善。

方法

检索了 PubMed、EMBASE 和 Cochrane 中央对照试验注册库，直至 2020 年 9 月 28 日。纳入了比较有和无肌病患者的 25OHD 水平或检测补充维生素 D 对他汀类药物相关的肌肉不耐受的影响的原始研究。进行了基于样本量和基线 25OHD 水平的亚组分析。

结果

这项荟萃分析基于 9 项共 2906 名患者的队列研究，显示他汀类相关肌病患者的 25OHD 水平显着低于非肌病患者 [加权平均差 - 4.17 ng/mL；95% 置信区间 (CI) - 7.70 至 - 0.63；p  = 0.021]。对另外四项研究的总体分析对 446 名先前缺乏维生素 D 并报告与他汀类药物相关的肌肉不耐受的患者进行了总体分析，结果表明 补充维生素 D 后他汀类药物的综合耐受率提高到 89%（95% CI 8692； p < 0.001）。

结论

目前的荟萃分析提供的证据表明，低 25OHD 水平与他汀类药物相关的肌病相关，并且在大多数情况下，外源性维生素 D 补充剂可以改善与低 25OHD 水平相关的他汀类药物相关的肌肉不耐受。我们的研究结果可能为他汀类药物相关肌病的预防和治疗提供有用的见解。