The effect of tamoxifen as an adjuvant therapy for breast cancer on apolipoproteins and lipoprotein(a) concentrations in women: A meta-analysis of randomized controlled trials

IF 3.9

Experimental gerontology Pub Date : 2024-10-11 DOI:10.1016/j.exger.2024.112587

Bohua Zhang , Yafang Huang , Jingjing Zhang , Wenbo Fu , Kousalya Prabahar , Benjamin Hernández-Wolters , Hua Hu , Fei Hao

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Abstract

Background and aim

Tamoxifen has been used in the management of breast cancer. The available evidence on the effect of tamoxifen on lipoprotein(a) and apolipoproteins is controversial. Hence, this meta-analysis of randomized controlled trials (RCTs) was conducted to increase the quality of evidence on the effect of tamoxifen on lipoprotein(a) and apolipoproteins.

Methods

Eligible RCTs published up to September 2023 were carefully selected following a comprehensive search. Thereafter, a meta-analysis was conducted using a random-effects model and the results were presented as the weighted mean difference (WMD) with a 95 % confidence interval (CI).

Results

The results from the random-effects model indicated a rise in ApoA-I (WMD: 16.24 mg/dL, 95 % CI: 5.35, 27.12, P = 0.003), and a decrease in ApoB (WMD: −9.37 mg/dL, 95 % CI: −15.16, −3.59, P = 0.001) and lipoprotein(a) (WMD: −3.24 mg/dL, 95 % CI: −5.66, −0.83, P < 0.001) concentrations following tamoxifen administration in women. Furthermore, a more pronounced decrease in ApoB (WMD: −12.86 mg/dL, 95 % CI: −19.78, −5.93, P < 0.001) and elevation in ApoA-1 levels (WMD: 51.97 mg/dL, 95 % CI: 45.89, 58.05, P < 0.001) were identified in a single study on patients with breast cancer.

Conclusion

The current meta-analysis demonstrated an increase of ApoA-I and a decrease of ApoB and lipoprotein(a) levels after treatment with tamoxifen in women.

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他莫昔芬作为乳腺癌辅助疗法对妇女体内脂蛋白和脂蛋白（a）浓度的影响：随机对照试验的荟萃分析。

背景和目的：他莫昔芬一直被用于治疗乳腺癌。关于他莫昔芬对脂蛋白（a）和脂蛋白的影响，现有证据尚存在争议。因此，我们对随机对照试验（RCTs）进行了荟萃分析，以提高他莫昔芬对脂蛋白（a）和脂蛋白影响的证据质量：方法：经过全面检索，精心挑选了截至 2023 年 9 月发表的符合条件的随机对照试验。随后，采用随机效应模型进行了荟萃分析，结果以加权平均差（WMD）和95%置信区间（CI）表示：随机效应模型的结果显示载脂蛋白 A-I 上升（WMD：16.24 mg/dL，95 % CI：5.35, 27.12，P = 0.003），载脂蛋白 B 下降（WMD：-9.37 mg/dL，95 % CI：-15.16, -3.59，P = 0.001），脂蛋白（a）下降（WMD：-3.24 mg/dL，95 % CI：-5.66, -0.83，P 结论：目前的荟萃分析表明，妇女使用他莫昔芬治疗后，载脂蛋白 A-I 水平升高，载脂蛋白 B 和脂蛋白（a）水平降低。

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