Statin Use and Coronary Artery Calcification:a Systematic Review and Meta-analysis of Observational Studies and Randomized Controlled Trials

Purpose of Review: This review aimed to determine the association between statin use and coronary artery calcification (CAC), as detected by computed tomography in the general population, in previously published observational studies (OSs) and randomized controlled trials (RCTs). Recent Findings: A systematic search until February 2022 identified 41 relevant studies, comprising 29 OSs and 12 RCTs. We employed six meta-analysis models, stratifying studies based on design and effect metrics. For cohort studies, the pooled β of the association with CAC quantified by the Agatston score was 0.11 (95% CI = 0.05; 0.16), with an average follow-up time per person (AFTP) of 3.68 years. Cross-sectional studies indicated a pooled odds ratio of 2.11 (95% CI = 1.61; 2.78) for the presence of CAC. In RCTs, the pooled standardized mean differences (SMDs) for CAC, quantified by Agatston score or volume, over and AFTP of 1.25 years were not statistically significant (SMD = − 0.06, 95% CI = − 0.19; 0.06 and SMD = 0.26, 95% CI = − 0.66; 1.19), but significantly different (p-value = 0.04). Meta-regression and subgroup analyses did not show any significant differences in pooled estimates across covariates. Summary: The effect of statins on CAC differs across study designs. OSs demonstrate associations between statin use and higher CAC scores and presence while being prone to confounding by indication. Effects from RCTs do not reach statistical significance and vary depending on the quantification method, hampering drawing conclusions. Further investigations are required to address the limitations inherent in each approach.</p

AdDIT Editorial comment—challenges in medication treatment of renal and cardiovascular diseases and risk factors in adolescents with type 1 diabetes

A large body of evidence revealed that compared with children and adolescents in the general population, those with type 1 diabetes mellitus (T1DM) are at excessive risk of diabetes related complications (1,2). Presence and long-term diabetes complications are known to increase cardiovascular (CV) morbidity and mortality in population with T1DM in which 26.1% of all deaths are associated with diabetes complications (3)

Mining treatment patterns of glucose-lowering medications for type 2 diabetes in the Netherlands

Rationale and objectives Different classes of glucose-lowering medications are used for patients with type 2 diabetes mellitus (T2DM) management. It is unclear how often these medications are prescribed in clinical practice. In this study, we aimed to describe treatment patterns of glucose-lowering medications in patients with T2DM in the Netherlands. Methods We studied a cohort of 73 819 patients with T2DM, aged ≥45 years with a first prescription for oral glucose-lowering medication between 2011 and 2017. We used the NControl database with dispensing data from 800 pharmacies in the Netherlands. Prevalence of each glucose-lowering medication class during 6 years after the index date was calculated. Using SQL Server, we identified stepwise patterns of medication prescription in this population. Findings During the study period, prevalence of biguanides (BIGU) decreased from 95.6% to 80.8% and use of sulfonylureas (SU) increased from 27.3% to 42.3%. 55.2% of all patient

Research Paper: The antinociceptive effects of rosuvastatin in chronic constriction injury model of male rats

Introduction: According to studies, statins possess analgesics and anti-inflammatory properties. In the present study, we examined the antinociceptive, anti-inflammatory and antioxidative effects of rosuvastatin in an experimental model of Chronic Constriction Injury (CCI). Methods: Our study was conducted on four groups; sham, CCI (the control group), CCI+rosuvastatin (i.p. 5 mg/kg), and CCI+rosuvastatin (i.p. 10 mg/kg). We performed heat hyperalgesia, cold and mechanical allodynia tests on the 3rd, 7th, 14th, and 21st after inducing CCI. Blood samples were collected to measure the serum levels of Tumor Necrosis Factor (TNF)-α, and Interleukin (IL)-6. Rats' spinal cords were also examined to measure tissue concentration of Malondialdehyde (MDA), Superoxide Dismutase (SOD), and Glutathione Peroxidase (GPx) enzymes. Results: Our findings showed that CCI resulted in significant increase in heat hyperalgesia, cold and mechanical allodynia on the 7th, 14th and 21st day. Rosuvastatin use attenuated the CCI-induced hyperalgesia and allodynia. Rosuvastatin use also resulted in reduction of TNF-α, IL-6, and MDA levels. However, rosuvastatin therapy increased the concentration of SOD and GPx in the CCI+Ros (5 mg/kg) and the CCI+Ros (10 mg/kg) groups compared to the CCI group. Conclusion: Rosuvastatin attenuated the CCI-induced neuropathic pain and inflammation. Thus, antinociceptive effects of rosuvastatin might be channeled through inhibition of inflammatory biomarkers and antioxidant properties

The Antinociceptive Effects of Rosuvastatin in Chronic Constriction Injury Model of Male Rats

Introduction: According to studies, statins possess analgesics and anti-inflammatory properties. In the present study, we examined the antinociceptive, anti-inflammatory and antioxidative effects of rosuvastatin in an experimental model of Chronic Constriction Injury (CCI). Methods: Our study was conducted on four groups; sham, CCI (the control group), CCI+rosuvastatin (i.p. 5 mg/kg), and CCI+rosuvastatin (i.p. 10 mg/kg). We performed heat hyperalgesia, cold and mechanical allodynia tests on the 3rd, 7th, 14th, and 21st after inducing CCI. Blood samples were collected to measure the serum levels of Tumor Necrosis Factor (TNF)-α, and Interleukin (IL)-6. Rats' spinal cords were also examined to measure tissue concentration of Malondialdehyde (MDA), Superoxide Dismutase (SOD), and Glutathione Peroxidase (GPx) enzymes. Results: Our findings showed that CCI resulted in significant increase in heat hyperalgesia, cold and mechanical allodynia on the 7th, 14th and 21st day. Rosuvastatin use attenuated the CCI-induced hyperalgesia and allodynia. Rosuvastatin use also resulted in reduction of TNF-α, IL-6, and MDA levels. However, rosuvastatin therapy increased the concentration of SOD and GPx in the CCI+Ros (5 mg/kg) and the CCI+Ros (10 mg/kg) groups compared to the CCI group. Conclusion: Rosuvastatin attenuated the CCI-induced neuropathic pain and inflammation. Thus, antinociceptive effects of rosuvastatin might be channeled through inhibition of inflammatory biomarkers and antioxidant propertie

Early life antibiotic exposure is associated with an increased risk of atopic eczema and hay fever

Background: Several studies suggested that early life exposure to antibiotics is associated with an increased risk of developing allergies later in life, but results are inconsistent. In this study we aimed to systematically review and quantify the relationship between early life exposure to antibiotics and the risk of atopic eczema (dermatitis) or hay fever (allergic rhinitis). Method: PubMed and Web of Science databases were searched for observational studies published from January 1966 through November 11, 2015. Studies were included that assessed the association between antibiotic consumption during the first 2 years of life and the risk of eczema or hay fever later in life. Separate metaanalyses were performed to assess the risk estimates for cohort studies, cross sectional studies and case control studies. Furthermore, in subgroup analyses the effect of child's age at the time of antibiotic use/diagnosis of allergies, and the number of courses of antibiotic treatments have been analyzed. Overall pooled estimates of the odds ratios (ORs) were obtained using fixed or random-effects models. Results: Twenty-two studies (including 394 517 patients) were selected to study the risk of eczema and 23 studies (including 256 609 patients) to study the risk of hay fever. In all separate meta-analyses of the distinct study designs, those who were exposed to antibiotics early in life were found to have a statistically significantly increased risk of eczema and hay fever. The summary OR for risk of eczema were 1.24 (95% CI, 1.09-1.41; I2: 60.0%) in the meta-analyses of the cohort studies (n = 50 824); 1.41 (95% CI, 1.33-1.49; I2: 0.0%) in the cross sectional studies (n = 217 752), and 1.15 (95% CI, 1.01- 1.42; I2: 79.5%) in the case control studies (n = 125 941). The summary OR for risk of hay fever were 1.18 (95% CI, 1.01-1.37; I2: 74.3%) in the cohort studies (n = 46 540); 1.56 (95% CI, 1.29-1.90; I2: 63.6%) in cross sectional studies (n = 27 608), and 1.14 (95% CI, 1.04-1.26; I2: 64.8%) in the case control studies (n = 182 461). In subgroup analyses, there was no statistically significant effect of the child's age at time of antibiotic use as well as the time of allergy diagnosis on these associations. The association was stronger if patients had been treated with ≥2 courses compared with one course of antibiotics both for eczema and for hay fever. Conclusion: Early life exposure to antibiotics is related to an increased risk of both atopic eczema and hay fever later in life

The effects of statin use on inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials

Current evidence suggests that statin use decreases the incidence of cardiovascular diseases (CVD) through reducing LDL cholesterol and decreasing inflammation. Metabolic syndrome (MetS) is usually associated with increased inflammatory markers and increased risk of CVD. We conducted a systematic review and meta-analysis to determine the effect of statin use on inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1 (IL-1) among patients with MetS and related disorders. PubMed, EMBASE, Web of Science databases, and Cochrane Library were searched for randomized controlled trials (RCTs) through April 2018. Three independent investigators evaluated study eligibilities, extracted data, and assessed study quality using the Cochrane Collaboration risk of bias tool and Jadad's quality scales. Heterogeneity was determined using Cochran's Q statistic and I-square (I 2 ) test. Based on the heterogeneity results, we pooled data using random-effect or fixed effect models presented as standardized mean differences (SMD) and corresponding 95 confidence intervals (CI). One hundred thirteen RCTs (19,644 patients) were included in our meta-analysis. The pooled results using random effects model showed that statin use statistically significantly decreased CRP level (SMD= -0.97; 95 CI, -1.10, -0.85; P &lt; 0.001; I 2 : 95.1), TNF-α (SMD= -1.88; 95 CI, -2.40, -1.38; P &lt; 0.001; I 2 : 97.2), IL-6 (SMD= -1.67; 95 CI, -1.98, -1.34; P &lt; 0.001; I 2 : 96.5), and IL-1 concentrations (SMD= -8.35; 95 CI, -10.49, -6.22; P &lt; 0.001; I 2 : 98.4) among patients with MetS and related disorders. Our meta-analysis showed beneficial effects of statin use on reducing inflammatory markers in patients with MetS and related disorders. © 2018 Elsevier Lt