阿托伐他汀对肾脏疾病患者炎症标志物、血脂和肾功能的影响：随机对照试验的系统回顾和荟萃分析

IF 2.7

Advances in redox research : an official journal of the Society for Redox Biology and Medicine and the Society for Free Radical Research-Europe Pub Date : 2026-03-01 Epub Date: 2026-01-02 DOI:10.1016/j.arres.2026.100150

Iman Mohammadi , Behzad Einollahi , Mina Alimohammadi , Seyedeh Mahdieh Khoshnazar , Hoda Sadeghi , Ali Zahiri , Haniye Najafzadeh , Kiavash Hushmandi

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引用次数: 0

摘要

慢性和急性肾脏疾病（CKD， AKI）折磨着全球数百万人，导致发病率和死亡率增加，特别是心血管后果。阿托伐他汀是一种流行的他汀类药物，具有降脂、抗炎和抗氧化的特性，可能有助于肾脏疾病患者的肾脏和心血管健康。本荟萃分析评估了阿托伐他汀在肾脏疾病患者的脂质谱、炎症生物标志物和肾功能方面的有效性和安全性。方法全面检索Scopus、Cochrane、Embase、Web of Science、b谷歌Scholar和PubMed，直到2025年1月，发现了评价阿托伐他汀治疗CKD、糖尿病肾病、血液透析和其他肾脏疾病的随机对照试验（RCTs）。结果包括脂质参数（HDL、LDL、总胆固醇、甘油三酯）、炎症标志物（hsCRP、IL-6、MDA）和肾功能指标。随机效应模型用于合并加权平均差（wmd）和95%置信区间（ci）。根据剂量、持续时间、疾病类型和治疗方式进行亚组分析。评估偏倚和发表偏倚风险。结果纳入12项随机对照试验，共18项试验，样本量为21 ~ 156人。正如预期的那样，阿托伐他汀显著改善了高密度脂蛋白胆固醇（WMD: 2.74 mg/dL; 95% CI: 0.57至4.91;p < 0.001），同时显著降低了低密度脂蛋白胆固醇（WMD: -13.09 mg/dL; 95% CI: -21.17至-5.00;p < 0.001）和总胆固醇（WMD: -15.28 mg/dL; 95% CI: -24.58至-5.98;p < 0.001），剂量≤10 mg/天且疗程较长。更值得注意的是，它还降低了丙二醛（WMD: -2.80; 95% CI: -3.62至-1.97;p < 0.001），并通过降低≤10mg /天剂量的CKD患者的hsCRP显示出抗炎作用。结论托伐他汀可改善肾脏疾病患者的脂质谱，降低氧化应激指标，在某些亚组中有炎症减少的迹象，表明托伐他汀可能具有降低心血管风险的辅助治疗功能。未来需要大规模随机对照试验来确定合适的剂量和长期肾脏结果。

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The effect of atorvastatin on inflammatory markers, lipid profile, and renal function in kidney diseases: a systematic review and meta-analysis of randomized controlled trials

Background

Chronic and acute kidney disorders (CKD, AKI) afflict millions globally, leading to increased morbidity and death, especially from cardiovascular consequences. Atorvastatin, a popular statin, offers lipid-lowering, anti-inflammatory, and antioxidant qualities that may assist kidney disease patients in terms of renal and cardiovascular health. This meta-analysis assesses atorvastatin's effectiveness and safety in terms of lipid profiles, inflammatory biomarkers, and renal function in patients with kidney disorders.

Methods

A thorough search of Scopus, Cochrane, Embase, Web of Science, Google Scholar, and PubMed until January 2025 revealed randomized controlled trials (RCTs) evaluating atorvastatin in CKD, diabetic nephropathy, hemodialysis, and other renal diseases. The outcomes included lipid parameters (HDL, LDL, total cholesterol, triglycerides), inflammatory markers (hsCRP, IL-6, MDA), and renal function indices. Random-effects models were used to pool weighted mean differences (WMDs) and 95 % confidence intervals (CIs). Subgroup analyses were performed based on dosage, duration, disease type, and treatment type. The risk of bias and publication bias was evaluated.

Results

Twelve RCTs with 18 trials and sample sizes ranging from 21 to 156 participants were included. As expected, atorvastatin significantly improved HDL cholesterol (WMD: 2.74 mg/dL; 95 % CI: 0.57 to 4.91; p < 0.001) while dramatically decreasing LDL cholesterol (WMD: -13.09 mg/dL; 95 % CI: -21.17 to -5.00; p < 0.001) and total cholesterol (WMD: -15.28 mg/dL; 95 % CI: -24.58 to -5.98; p < 0.001) at lower dosages of ≤10 mg/day and longer treatment periods. More notably, it also reduced MDA (WMD: -2.80; 95 % CI: -3.62 to -1.97; p < 0.001) and showed anti-inflammatory effects by reducing hsCRP in CKD patients receiving a ≤ 10 mg/day dosage.

Conclusions

Atorvastatin medication improves lipid profiles and lowers oxidative stress indicators in renal disease patients, with some indications of decreased inflammation in select subgroups, indicating a possible function as an adjuvant treatment to reduce cardiovascular risk. Future large-scale RCTs are needed to determine the appropriate dose and long-term kidney results.

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