芳香化酶抑制剂对绝经后激素受体阳性乳腺癌患者血脂影响的meta分析

Meta-analysis of effects of aromatase inhibitors on blood lipids in breast cancer patients with postmenopausal positive hormone receptor

目的使用meta法分析芳香化酶抑制剂(AIs)对绝经后激素受体阳性乳腺癌患者血脂的影响。方法通过计算机检索PubMed、Embase数据库筛选相关数据。使用Review Manager 5.3软件分析甾体和非甾体类AIs对绝经后激素受体阳性乳腺癌患者血脂的影响。结果所涉1 5074人中发生血脂异常者4 937人。相比于非甾体AIs,甾体AIs发生血脂异常的风险相对较低(OR=0.83;95%CI:0.77~0.89;P<0.001)。亚组分析发现,相比于非甾体AIs,甾体AIs发生甘油三酯异常的风险相对较低(OR=0.81;95%CI:0.71~0.92;P=0.001)、发生胆固醇异常的风险相对较低(OR=0.83;95%CI:0.76~0.91;P<0.001)。结论 meta分析显示,选择甾体类的AIs治疗绝经后激素受体阳性乳腺癌患者发生血脂异常的风险更小。亚组分析显示,对甘油三脂和胆固醇异常的相关患者更偏向选择甾体类AIs药物。

Objective To analyze the effects of aromatase inhibitors(AIs)on blood lipids in breast cancer patients with postmenopausal positive hormone receptor.Methods Databases PubMed and EMBASE were searched by computer to screen the relevant data.Software Review Manager 5.3 was used to analyze the effects of steroidal and non-steroidal AIs on blood lipids in breast cancer patients with postmenopausal positive hormone receptor.Results A total of 4937 patients had dyslipidemia among the 1 5074 patients involved.Steroidal AIs had a lower risk of dyslipidemia compared with non-steroidal AIs(OR=0.83;95%CI:0.77~0.89;P<0.001).Subgroup analysis showed that compared with non-steroidal AIs, the risk of abnormal triglyceride(OR=0.81;95%CI:0.71~0.92;P=0.001)and abnormal cholesterol(OR=0.83;95%CI:0.76~0.91;P<0.001)was relatively low in steroidal AIs.Conclusions Meta-analysis showed that the risk of dyslipidemia was lower in AIs treatment with steroids.Subgroup analysis showed that patients with abnormal triglyceride and cholesterol preferred steroidal AIs drugs.