6533b7d9fe1ef96bd126c2db

RESEARCH PRODUCT

Analysis of vitamin D levels in patients with and without statin-associated myalgia — A systematic review and meta-analysis of 7 studies with 2420 patients

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article i nfo Introduction: VitaminD (vitD)deficiencymay beassociatedwith anincreased riskof statin-related symptomatic myalgia in statin-treated patients. The aim of this meta-analysis was to substantiate the role of serum vitamin D levels in statin-associated myalgia. Methods: The search included PUBMED, Cochrane Library, Scopus, and EMBASE from January 1, 1987 to April 1, 2014 to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. Two independent reviewers extracted data on study characteristics, methods and outcomes. Quantita- tive data synthesis was performed using a fixed-effect model. Results: The electronic search yielded 437 articles; of those 20 were scrutinized as full texts and 13 studies were considered unsuitable. The final analysis included 7 studies with 2420 statin-treated patients divided into sub- groups of patients with (n = 666 (27.5%)) or without (n = 1754) myalgia. Plasma vit D concentrations in the symptomatic and asymptomatic subgroups were 28.4 ± 13.80 ng/mL and 34.86 ± 11.63 ng/mL, respectively. ThecombinationofdatafromindividualobservationalstudiesshowedthatvitDplasmaconcentrationsweresig- nificantly lower in patients with statin-associated myalgia compared with patients not manifesting this side ef- fect (weighted mean difference −9.41 ng/mL; 95% confidence interval: −10.17 to −8.64; p b 0.00001). Conclusions:Thismeta-analysis providesevidencethat low vit D levelsare associated with myalgiainpatientson statin therapy. Randomized controlled trials are necessary to establish whether vitamin D supplementation re- duces the risk for statin-associated myalgia.