Meta-analysis of the effects of statin therapy on endothelial function in patients with diabetes mellitus
Zhang L et al. – Statins significantly improved the flow–mediated dilatation (FMD) only in patients with better endothelial functions. The use of FMD in evaluating therapeutic outcomes should be careful in populations at high risk.Methods
- PubMed, Cochrane and Embase were searched for randomized controlled trials of statins.
- Only trials reporting changes in flow–mediated dilatation (FMD) were included in this analysis.
- A meta–analysis was performed to assess the relationship between statin therapy and improvements in endothelial dysfunction.
- Meta–regression and subgroup analyses were done to identify sources of heterogeneity.
- Ten statin studies (845 patients) were included in this analysis.
- Statin therapy significantly improved FMD in patients with DM [weighted mean difference (WMD): 0.94%; 95% CI: 0.38%, 1.5%; P<0.001].
- Although heterogeneity among trials was found (I2: 67%), no significant publication bias was detected.
- Subgroup analyses showed that patients did not benefit from statin therapy if their body mass index (BMI) was>27.6kg/m2 (four trials; I2: 0%; WMD: 0.11%; 95% CI: –0.47%, 0.70%; P=0.70).
- However, FMD was significantly improved among patients with BMI ≤27.6kg/m2 (five trials; I2: 14%; WMD: 1.52%; 95% CI: 1.19%, 1.85%; P<0.001).
- Type 1 diabetes, younger age, lower baseline blood lipid levels and blood pressure were all associated with improvements in FMD.
- The meta–regression analysis yielded similar results.