Statin Use and the Risk of Developing Graves’ Orbitopathy in Patients With Graves’ Disease: A Systematic Review and Meta-Analysis With Regional and Gender-Stratified Analyses
Notice bibliographique
Résumé
Graves' orbitopathy (GO) is a clinically significant extrathyroidal manifestation of Graves' disease (GD), often resulting in functional and cosmetic morbidity. Preventive strategies remain limited. Statins, widely prescribed for cardiovascular disease, possess anti-inflammatory and immunomodulatory properties that may also mitigate the risk of GO. This systematic review and meta-analysis aimed to evaluate the association between statin use and GO risk in GD, with subgroup analyses by geographic region and sex to capture potential differential effects. This study was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, the Excerpta Medica database (Embase), and the Cochrane Library were systematically searched from database inception through May 2025 using a predetermined strategy. Eligible observational studies (cohort or case-control) assessing the effect of statin use on incident GO were included. Where feasible, pooled hazard ratios (HRs) or odds ratios (ORs) were estimated using random-effects models (Western cohorts). For Asian populations, effect estimates were synthesized narratively due to heterogeneity in effect measures. Two reviewers independently performed study selection, data extraction, and risk of bias assessment using the ROBINS-I tool. The protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD420251032246). Five studies (n = 156,926) met the inclusion criteria. In Asian populations (n = 113,628), statin use was associated with a significantly reduced risk of GO (HR = 0.56; 95% CI: 0.46-0.68; p < 0.001). In Western populations (n = 43,298), pooled analysis suggested a non-significant trend toward risk reduction (HR = 0.76; 95% CI: 0.53-1.10; p = 0.14), with substantial heterogeneity (I² = 60.8%). Among Asian females (n = 83,997), statin use consistently demonstrated protective associations (HRs 0.37-0.66), while male subgroup estimates, derived from a single study, were not statistically significant. Across all studies, risk of bias was rated as moderate, primarily due to confounding and variability in outcome measurement. Statin use appears to reduce the risk of GO among patients with GD, with the strongest protective effect observed in Asian women. Although Western data suggested a protective trend, findings did not reach statistical significance and were limited by heterogeneity. These results highlight the importance of region- and sex-specific investigations. Large-scale prospective cohort studies and randomized controlled trials (RCTs) are warranted to confirm the potential preventive role of statins in GO and to clarify dose-response relationships.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,006 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».