郑州大学第一附属医院药学部,郑州 450052
Received:07 March 2024,
Revised:2024-07-22,
Accepted:22 July 2024,
Published:15 October 2024
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鲁春云,王松,刘克锋,等.SLCO1B1基因多态性对瑞舒伐他汀有效性和安全性影响的Meta分析[J].中国药房,2024,35(19):2397-2403.
LU Chunyun,WANG Song,LIU Kefeng,et al.Meta-analysis of the effects of SLCO1B1 gene polymorphisms on the efficacy and safety of rosuvastatin[J].ZHONGGUO YAOFANG,2024,35(19):2397-2403.
鲁春云,王松,刘克锋,等.SLCO1B1基因多态性对瑞舒伐他汀有效性和安全性影响的Meta分析[J].中国药房,2024,35(19):2397-2403. DOI: 10.6039/j.issn.1001-0408.2024.19.13.
LU Chunyun,WANG Song,LIU Kefeng,et al.Meta-analysis of the effects of SLCO1B1 gene polymorphisms on the efficacy and safety of rosuvastatin[J].ZHONGGUO YAOFANG,2024,35(19):2397-2403. DOI: 10.6039/j.issn.1001-0408.2024.19.13.
目的
2
研究
SLCO1B1
基因(521T>C和388A>G)多态性与瑞舒伐他汀有效性和安全性的相关性。
方法
2
在PubMed、Embase、Cochrane Library、PharmGKB、中国知网和万方数据库中检索521T>C和388A>G基因多态性对瑞舒伐他汀有效性和安全性影响的研究,检索时限为建库起至2023年12月,用RevMan 5.3软件对所纳入的数据进行分析。
结果
2
共纳入16篇相关研究。Meta 分析结果显示,521T>C基因多态性与瑞舒伐他汀疗效有显著相关性——在显性基因模型下,与TT基因型相比,CC+TC基因型能显著提高瑞舒伐他汀升高高密度脂蛋白胆固醇(HDL-C)的疗效[MD=2.38,95%CI(0.61,4.16),
P
=0.009 0
]
;在纯合子基因模型下,与TT基因型相
比,CC基因型能显著提高瑞舒伐他汀降低总胆固醇的疗效[MD=-7.50,95%CI(-13.05,-1.95),
P
=0.008 0
]
;在杂合子基因模型下,与TT基因型相比,TC基因型能显著提高瑞舒伐他汀降低低密度脂蛋白胆固醇(LDL-C)[MD= -5.14,95%CI(-9.74,-0.53),
P
=0.03
]
和升高HDL-C[MD=5.67,95%CI(2.61,8.73),
P
=0.000 3
]
的疗效。388A>G基因多态性与瑞舒伐他汀疗效亦有显著相关性——在显性或纯合子基因模型下,与AA基因型相比,GG+AG基因型[MD=-6.88,95%CI (-7.46,-6.30),
P
<0.000 1
]
或GG基因型[MD=-9.23,95%CI(-9.41,-9.04),
P
<0.000 1
]
能显著提高瑞舒伐他汀降低LDL-C的疗效;在杂合子基因模型下,与AA基因型相比,AG基因型能显著提高瑞舒伐他汀降低LDL-C[MD=-3.00,95%CI(-3.19, -2.82),
P
<0.000 1
]
、总胆固醇[MD=-5.80,95%CI(-6.00,-5.59),
P
<0.000 1
]
和甘油三酯[MD=-11.79,95%CI(-19.57, -4.02),
P
=0.003 0
]
的疗效;在隐性基因模型下,与AA+AG基因型相比,GG基因型能显著提高瑞舒伐他汀降低LDL-C[MD= -4.31,95%CI(-8.47,-0.14),
P
=0.040 0
]
和升高HDL-C[MD=4.49,95%CI(2.20,6.77),
P
=0.000 1
]
的疗效。4种基因模型下,521T>C基因多态性与瑞舒伐他汀相关ADR发生概率之间均存在显著相关性(
P
<0.05),但并未发现388A>G基因多态性与瑞舒伐他汀相关ADR发生概率之间存在显著相关性(
P
>0.05)。
结论
2
521T>C基因多态性与瑞舒伐他汀的降脂疗效和安全性显著相关,C等位基因可能是导致瑞舒伐他汀降脂疗效增强和ADR增多的因素之一;388A>G基因多态性与瑞舒伐他汀的降脂疗效显著相关,但与其安全性无关联性。
OBJECTIVE
2
To study the correlation between
SLCO1B1
(521T>C and 388A>G) gene polymorphisms and the efficacy and safety of rosuvastatin.
METHODS
2
Retrieved from PubMed, Embase, Cochrane Library, PharmGKB, CNKI database and Wanfang database, the studies about the effects of 521T>C and 388A>G gene polymorphisms on the efficacy and safety of rosuvastatin were collected during the inception to Dec. 2023. The included data were analyzed by using RevMan 5.3 software.
RESULTS
2
A total of 16 studies were included. The results of meta-analysis showed that 521T>C gene polymorphism was significantly correlated with the efficacy of rosuvastatin. In the dominant gene model, compared with TT genotype, CC+TC genotype significantly improved the effica
cy of rosuvastatin in raising high-density lipoprotein cholesterol (HDL-C) [MD=2.38, 95%CI(0.61,4.16),
P
=0.009 0
]
. In the homozygous gene model, compared with TT genotype, CC genotype significantly improved the efficacy of rosuvastatin in reducing total cholesterol [MD=-7.50,95%CI(-13.05, -1.95),
P
=0.008 0
]
. In heterozygous gene model, compared with TT genotype, TC genotype significantly improved rosuvastatin in reducing low-density lipoprotein cholesterol (LDL-C) [MD=-5.14, 95%CI(-9.74, -0.53),
P
=0.03
]
and increasing HDL-C [MD=5.67, 95%CI(2.61, 8.73),
P
=0.000 3
]
. 388A>G gene polymorphism was also significantly correlated with the efficacy of rosuvastatin. In dominant or homozygous gene models, compared with AA genotype, GG+AG genotype [MD=-6.88, 95%CI (-7.46, -6.30),
P
<0.000 1
]
or GG genotype [MD=-9.23, 95%CI(-9.41, 9.04),
P
<0.000 1
]
significantly improved the efficacy of rosuvastatin in lowering LDL-C. In the heterozygous gene model, compared with AA genotype, AG genotype significantly improved the efficacy of rosuvastatin in lowering LDL-C [MD=-3.00, 95%CI(-3.19, -2.82),
P
<0.000 1
]
, total cholesterol [MD=-5.80, 95%CI(-6.00, -5.59),
P
<0.000 1
]
and triglyceride [MD=-11.79, 95%CI(-19.57, -4.02),
P
=0.003 0
]
. In the recessive gene model, compared with AA+AG genotype, GG genotype significantly improved the therapeutic efficacy of rosuvastatin in reducing LDL-C[MD=-4.31, 95%CI(-8.47, -0.14),
P
=0.040 0
]
and elevating HDL-C [MD=4.49, 95%CI(2.20, 6.77),
P
=0.000 1
]
. Under 4 gene models, there was a significant correlation between 521T>C gene polymorphism and rosuvastatin-related ADR probability (
P
<0.05), but no significant correlation was found in 388A>G gene polymorphism (
P
>0.05).
CONCLUSIONS
2
The polymorphism of 521T>C gene is significantly related to the efficacy and safety of rosuvastatin in lowering lipid, and the C allele may be one of the factors leading to the increase of rosuvastatin in lipid-lowering efficacy and ADR. 388A>G gene polymorphism is significantly associated with the lipid-lowering efficacy of rosuvastatin, but not with its safety.
田余 . ApoE/SLCO1B1基因多态性对血脂异常患者应用瑞舒伐他汀的影响 [D ] . 呼和浩特 : 内蒙古医科大学 , 2019 .
TIAN Y . The effect of ApoE/SLCO1B1 gene polymorphism on the application of rosuvastatin in patients with dyslipidemia [D ] . Hohhot : Inner Mongolia Medical University , 2019 .
李静 , 袁圆 , 马丽娟 , 等 . SLCO1B1和ApoE基因多态性对不同种类中等强度剂量他汀降脂疗效的影响 [J ] . 中国临床药理学杂志 , 2023 , 39 ( 18 ): 2626 - 2630 .
LI J , YUAN Y , MA L J , et al . Effects of SLCO1B1 and ApoE gene polymorphisms on the lipid-lowering efficacy of different types of moderate-intensity doses of statins [J ] . Chin J Clin Pharmacol , 2023 , 39 ( 18 ): 2626 - 2630 .
KIRAC D , BAYAM E , DAGDELEN M , et al . HMGCR and ApoE mutations may cause different responses to lipid lowering statin therapy [J ] . Cell Mol Biol (Noisy- legrand) , 2017 , 63 ( 10 ): 43 - 48 .
张刚 , 陈磊 , 李灵敏 , 等 . SLCO1B1 T521C基因多态性对他汀类药物药代动力学影响的Meta分析 [J ] . 第三军医大学学报 , 2017 , 39 ( 10 ): 1036 - 1043 .
ZHANG G , CHEN L , LI L M , et al . Influence of SLCO1B1 gene T521C polymorphism on pharmacokine- tics of HMG-CoA reductase inhibitors:a meta-analysis [J ] . J Third Mil Med Univ , 2017 , 39 ( 10 ): 1036 - 1043 .
闫恒瑜 . 甘肃地区SLCO1B1基因的分布特征及基因与他汀药物降脂疗效和的相关性研究 [D ] . 兰州 : 甘肃中医药大学 , 2019 .
YAN H Y . Distribution characteristics of SLCO1B1 gene in Gansu Province and the correlation between SLCO1B1 gene and lipid-lowering effect of statins [D ] . Lanzhou : Gansu University of Chinese Medicine , 2019 .
STANG A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses [J ] . Eur J Epidemiol , 2010 , 25 ( 9 ): 603 - 605 .
张昀赟 , 叶小磊 , 王美华 , 等 . SLCO1B1 521T>C基因多态性对瑞舒伐他汀钙降脂疗效的影响 [J ] . 中风与神经疾病杂志 , 2016 , 33 ( 6 ): 533 - 535 .
ZHANG Y Y , YE X L , WANG M H , et al . Effect of SLCO1B1 521T>C gene polymorphism on lipid lowing of rosuvastatin [J ] . J Apoplexy Nerv Dis , 2016 , 33 ( 6 ): 533 - 535 .
马占青 . 核受体和转运体基因多态性对瑞舒伐他汀降脂疗效的影响 [J ] . 心脑血管病防治 , 2020 , 20 ( 2 ): 139 - 142 .
MA Z Q . Influence of nuclear receptor and transporter gene polymorphism on the lipid-lowering effect of rosu- vastatin [J ] . Cardio Cerebrovasc Dis Prev Treat , 2020 , 20 ( 2 ): 139 - 142 .
贺红祥 , 李贵民 , 张文魁 , 等 . 有机阴离子转运体1B1与载脂蛋白E基因多态性分布及对服用瑞舒伐他汀的风险评估 [J ] . 心肺血管病杂志 , 2020 , 39 ( 11 ): 1346 - 1350 .
HE H X , LI G M , ZHANG W K , et al . Solute carrier organic anion transporter family member 1B1 and apolipoprotein E gene polymorphism distribution and risk assessment of using rosuvastatin [J ] . J Cardiovasc Pulm Dis , 2020 , 39 ( 11 ): 1346 - 1350 .
刘扬 , 宋翠云 , 赵正阳 , 等 . CYP3A5和COQ基因多态性对他汀类药物导致肌病病人的影响 [J ] . 中西医结合心脑血管病杂志 , 2021 , 19 ( 24 ): 4383 - 4387 .
LIU Y , SONG C Y , ZHAO Z Y , et al . Effects of CYP3A5 and COQ gene polymorphisms on statins-induced myopathy patients [J ] . Chin J Integr Med Cardio Cerebrovasc Dis , 2021 , 19 ( 24 ): 4383 - 4387 .
韩伟超 , 石韵宜 , 区淑雅 , 等 . SLCO1B1和ApoE基因多态性对瑞舒伐他汀疗效及安全性的影响 [J ] . 临床药物治疗杂志 , 2022 , 20 ( 10 ): 30 - 35 .
HAN W C , SHI Y Y , OU S Y , et al . Effects of SLCO1B1 and ApoE gene polymorphisms on therapeutic efficacy and safety of rosuvastatin [J ] . Clin Med J , 2022 , 20 ( 10 ): 30 - 35 .
王仲朝 , 李军 , 刘龙梅 , 等 . SLCO1B1/ApoE基因多态性与瑞舒伐他汀疗效及安全性的相关性研究 [J ] . 国际生物医学工程杂志 , 2016 , 39 ( 6 ): 358 - 361 .
WANG Z C , LI J , LIU L M , et al . SLCO1B1/ApoE gene polymorphisms associated with efficacy and safety of rosuvastatin [J ] . Int J Biomed Eng , 2016 , 39 ( 6 ): 358 - 361 .
谢东德 , 周思婕 , 黄杰 , 等 . SLCO1B1、ApoE基因多态性对瑞舒伐他汀治疗血脂异常超高危动脉粥样硬化性心血管疾病患者的影响 [J ] . 中国老年学杂志 , 2023 , 43 ( 4 ): 769 - 773 .
XIE D D , ZHOU S J , HUANG J , et al . Effect of SLCO1B1 and ApoE gene polymorphism on rosuvastatin in the treatment of patients with dyslipidemia and ultra-high risk atherosclerotic cardiovascular disease [J ] . Chin J Gerontol , 2023 , 43 ( 4 ): 769 - 773 .
张丹 , 辛文妤 , 杜雯雯 , 等 . SLCO1B1和ApoE基因多态性对瑞舒伐他汀调脂疗效及不良反应的影响 [J ] . 中国新药与临床杂志 , 2020 , 39 ( 1 ): 31 - 36 .
ZHANG D , XIN W Y , DU W W , et al . Effects of SLCO1B1/ApoE gene polymorphisms on lipid-lowering efficacy and adverse reactions of rosuvastatin [J ] . Chin J N Drugs Clin Remedies , 2020 , 39 ( 1 ): 31 - 36 .
RAMAKUMARI N , INDUMATHI B , KATKAM S K , et al . Impact of pharmacogenetics on statin-induced myopathy in South-Indian subjects [J ] . Indian Heart J , 2018 , 70 : S120 - S125 .
MERĆEP I , RADMAN I , TRKULJA V , et al . Loss of function polymorphisms in SLCO1B1 (c.521T>C,rs4149056) and ABCG2 (c.421C>A,rs2231142) genes are associated with adverse events of rosuvastatin:a case-control study [J ] . Eur J Clin Pharmacol , 2022 , 78 ( 2 ): 227 - 236 .
LIU J , LIU X Y , CHEN S , et al . SLCO1B1 521T>C polymorphism associated with rosuvastatin-induced myotoxicity in Chinese coronary artery disease patients:a nested case-control study [J ] . Eur J Clin Pharmacol , 2017 , 73 ( 11 ): 1409 - 1416 .
BAI X , ZHANG B , WANG P , et al . Effects of SLCO1B1 and GATM gene variants on rosuvastatin-induced myopathy are unrelated to high plasma exposure of rosuvastatin and its metabolites [J ] . Acta Pharmacol Sin , 2019 , 40 ( 4 ): 492 - 499 .
HU M , MAK V W L , TOMLINSON B . Intronic variants in SLCO1B1 related to statin-induced myopathy are associated with the low-density lipoprotein cholesterol response to statins in Chinese patients with hyperlipidaemia [J ] . Pharmacogenet Genomics , 2012 , 22 ( 11 ): 803 - 806 .
LEE H K , HU M , LUI S S , et al . Effects of polymorphisms in ABCG2,SLCO1B1,SLC10A1 and CYP2C9/19 on plasma concentrations of rosuvastatin and lipid response in Chinese patients [J ] . Pharmacogenomics , 2013 , 14 ( 11 ): 1283 - 1294 .
ZAKRIA M , HUSSAIN A , AHMAD N , et al . The lipid-lowering efficacy of rosuvastatin is associated with variations in SLCO1B1:a 12-month prospective cohort study [J ] . Eur Rev Med Pharmacol Sci , 2023 , 27 ( 10 ): 4708 - 4717 .
宋金方 , 赵懿清 , 葛重宇 , 等 . NOS1AP基因多态性对瑞舒伐他汀钙调脂效果的影响 [J ] . 中国药房 , 2017 , 28 ( 5 ): 577 - 581 .
SONG J F , ZHAO Y Q , GE C Y , et al . Effects of NOS1AP gene polymorphism on lipid-regulating response of rosuvastatin calcium [J ] . China Pharm , 2017 , 28 ( 5 ): 577 - 581 .
WAGNER J B , ABDEL-RAHMAN S , GAEDIGK A , et al . Impact of SLCO1B1 genetic variation on rosuvastatin systemic exposure in pediatric hypercholesterolemia [J ] . Clin Transl Sci , 2020 , 13 ( 3 ): 628 - 637 .
吴娜琼 , 郭远林 , 徐瑞霞 , 等 . 他汀类药物代谢相关基因多态性与疗效和安全性的关联 [J ] . 临床药物治疗杂志 , 2012 , 10 ( 6 ): 29 - 32 .
WU N Q , GUO Y L , XU R X , et al . Effect and safety of statins associated with the gene polymorphisms of drug metabolism [J ] . Clin Med J , 2012 , 10 ( 6 ): 29 - 32 .
薛阳 , 刘凯歌 . 有机阴离子转运多肽1B1(OATP1B1)基因多态性对他汀类药物影响的研究进展 [J ] . 现代药物与临床 , 2020 , 35 ( 4 ): 820 - 824 .
XUE Y , LIU K G . Research progress on effect of OATP1B1 gene polymorphism on statins [J ] . Drugs Clinic , 2020 , 35 ( 4 ): 820 - 824 .
BIRMINGHAM B K , BUJAC S R , ELSBY R , et al . Impact of ABCG2 and SLCO1B1 polymorphisms on pharmacokinetics of rosuvastatin,atorvastatin and simvastatin acid in Caucasian and Asian subjects:a class effect? [J ] . Eur J Clin Pharmacol , 2015 , 71 ( 3 ): 341 - 355 .
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