运动在他汀类药物相关肌肉症状结果中的作用:随机对照试验的系统回顾和元分析

Laura A. Mangone MS , Oh Sung Kwon PhD , Blair T. Johnson PhD , Yin Wu PhD , Linda S. Pescatello PhD
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引用次数: 0

摘要

患者和方法我们系统检索了 5 个电子数据库中截至 2023 年 1 月 31 日的安慰剂对照 RCT。我们纳入了短期和长期运动干预研究,这些研究比较了运动+他汀与运动+安慰剂对健康成人的疗效和安全性,并报告了干预前和干预后的 SAMS。结果在 454 项可能合格的 RCT 中,有 5 项符合纳入标准,均为短期运动 RCT。参与者主要是缺乏运动的中青年男性(M=37.2 岁)(57%),其中 252 人(49%)正在接受他汀类药物治疗,271 人(53%)正在接受安慰剂治疗。在提供SAMS定性结果的3项研究中,220名参与者中有19人(9%)报告了运动+他汀治疗的SAMS结果,234名参与者中有10人(4%)报告了运动+安慰剂治疗的SAMS结果。在最大耗氧量(d=-0.18;95% CI,-0.37 至 0.00;P=.06)或短期运动后肌酸激酶(d=0.59;95% CI,-0.06 至 1.25;P=.08)方面,运动+他汀组与运动+安慰剂组之间没有差异。与运动+安慰剂相比,运动+他汀组参与者的低密度脂蛋白胆固醇降低了(d=-1.84;95% CI,-2.28 至-1.39;P<.001)。结论他汀类药物使用者与安慰剂相比,短期运动后自我报告的SAMs往往高出5%,尽管这一差异未达到统计学意义。目前仍有必要进行安慰剂对照 RCT 研究,调查他汀类药物在运动训练期间引起的 SAMS 的发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective

To provide a synthesis of randomized controlled trials (RCTs) investigating statin-associated muscle symptoms (SAMS) in adults who underwent exercise training intervention.

Patients and Methods

We systematically searched 5 electronic databases for placebo-controlled RCTs through January 31, 2023. We included short-term and long-term exercise interventions that compared the efficacy and safety of exercise+statin vs exercise+placebo in healthy adults and reported SAMS preintervention and postintervention. Publication bias and methodological study quality assessments were performed.

Results

Five of 454 potentially qualifying RCTs met the inclusion criteria, all short-term exercise RCTs. Participants were predominantly physically inactive young to middle-aged (M=37.2 y) men (57%), 252 (49%) who were on statin therapy, and 271 (53%) on placebo. Of the 3 RCTs providing qualitative SAMS results, 19 (9%) out of 220 participants reported SAMS on exercise+statin and 10 (4%) out of 234 reported SAMS on exercise+placebo. There was no difference between exercise+statin vs exercise+placebo for maximal oxygen consumption (d=−0.18; 95% CI, −0.37 to 0.00; P=.06) or creatine kinase after short-term exercise (d=0.59; 95% CI, −0.06 to 1.25; P=.08). Participants in the exercise+statin group reduced low-density lipoprotein cholesterol vs exercise+placebo (d=−1.84; 95% CI, −2.28 to −1.39; P<.001). Most of the RCTs exhibited low levels of risk of bias (k=4, 80%) and achieved moderate methodological study quality (75.0%±5.2%).

Conclusion

Self-reported SAMs tended to be 5% greater after short-term exercise in statin users compared with placebo, although this difference did not achieve statistical significance. There remains an important need for placebo-controlled RCTs investigating the prevalence of statin-induced SAMS during exercise training.

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来源期刊
Mayo Clinic proceedings. Innovations, quality & outcomes
Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy
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