Ann Lab Med.  2015 May;35(3):329-335. 10.3343/alm.2015.35.3.329.

Meta-Analysis of the SLCO1B1 c.521T>C Variant Reveals Slight Influence on the Lipid-Lowering Efficacy of Statins

• Dou Y
• Zhu X
• Wang Q
• Tian X
• Cheng J
• Zhang E

• KMID: 2363205
• DOI: http://doi.org/10.3343/alm.2015.35.3.329

Abstract

BACKGROUND
Several studies have focused on the association between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C polymorphism; however, the results are conflicting. The effects of statins show significant variability between individuals. This meta-analysis aimed to investigate the effects of the SLCO1B1 c.521T>C polymorphism on the lipid-lowering effects of statins.
METHODS
We systematically searched PubMed and Web of Science to screen relevant studies. Meta-analysis was performed to identify the association between SLCO1B1 c.521 polymorphisms and the lipid-lowering effects of statinson the basis of the standard mean difference (SMD) and 95% confidence intervals (CIs). Additionally, we checked for heterogeneity (I 2) among studies and evidence of publication bias. We obtained eight studies including 2,012 wild genotype (T/T) and 526 variant genotype (T/C and C/C) cases.
RESULTS
No significant difference was observed in the lipid-lowering efficacy of statins between the wildand variant genotypes of SLCO1B1, with a pooled SMD of 0.03 (95% CI: -0.07-0.13). Furthermore, there was no significant effect in the meta-analyses of the variant heterozygote, homozygote, and Chinese populations. Subgroup meta-analysis indicated that the timerequired for the statin to take effectdid notsignificantly affect the association between lipid-lowering efficacy of statins and SLCO1B1 c.521T>C polymorphism. However, thewild genotype improved the lipid-lowering efficacy of simvastatin with a pooled SMD of -0.26 (95% CI: -0.47- -0.05).
CONCLUSIONS
No significant association was detected between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C polymorphism, with the exception of simvastatin.

Keyword

SLCO1B1 gene; Statins; Lipid-lowering effect; Meta-analysis

MeSH Terms

Alleles
Databases, Factual
Genotype
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
Hyperlipidemias/drug therapy/genetics
Polymorphism, Single Nucleotide
Solute Carrier Organic Anion Transporter Family Member 1b1/*genetics
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Solute Carrier Organic Anion Transporter Family Member 1b1

Figure

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  Fig. 1 Flow diagram of the study selection process.

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  Fig. 2 Forest plot of SMD for the association between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C polymorphism, and funnel plots for evaluating publication bias. *TC genotype; †CC genotype; *†TC and CC genotype.Abbreviations: SMD, standard mean difference; CI, confidence interval; df, degrees of freedom; S, simvastatin; A, atorvastatin; R, rosuvastatin; 4, 4 weeks; 8, 8 weeks.

• 

  Fig. 3 Forest plots and funnel plots of each subgroup. (A) Forest plots of SMD for the association between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C polymorphism of Chinese populations, and funnel plot for evaluating publication bias; (B) Forest plot of SMD for the association between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C heterozygous genotype, and funnel plot for evaluating publication bias; (C) Forest plot of SMD for the association between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C homozygote genotype, and funnel plotfor evaluating publication bias; (D) Forrest plot of SMD for the association between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C variant genotypes (T/C and C/C genotype), and funnel plot for evaluating publication bias. *TC genotype; †CC genotype; *†TC and CC genotype; S: simvastatin; A: atorvastatin; R: rosuvastatin; 4: 4 weeks; 8: 8 weeks.Abbreviations: SMD, standard mean difference; CI, confidence interval; df, degrees of freedom.

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