The effect of statin therapy in combination with ezetimibe on circulating C-reactive protein levels: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Previous studies have reported that statin or ezetimibe therapy has an anti-inflammatory effect. However, the results of individual studies on the effect of statin therapy in combination with ezetimibe on C-reactive protein (CRP) and high-sensitivity CRP (hs-CRP) levels have not been clear. Therefore, the present systematic review and meta-analysis were conducted on randomized clinical trials (RCTs) to evaluate the effect of statin therapy in combination with ezetimibe on CRP and hs-CRP levels. METHODS: A literature search was carried out on the MEDLINE, SciVerse Scopus, and Clarivate Analytics Web of Science databases up to February 2022 to find eligible studies. The pooled effect sizes were considered for weighted mean difference (WMD) and 95% confidence intervals (CI) for CRP and hs-CRP, and it was also determined as standardized weighted mean difference (SMD) for overall CRP. For all variables, a random-effects model was used. RESULTS: Of the 57 studies included in the systematic review, 53 were used for meta-analysis. Statin therapy in combination with ezetimibe significantly reduced the serum levels of hs-CRP (WMD - 0.2 mg/l; 95% CI - 0.4, - 0.1, P ˂ 0.001) and overall CRP (SMD - 0.16 mg/l; 95% CI - 0.2, - 0.07, P ˂ 0.001). Nevertheless, CRP levels were not significantly changed by combination therapy. A significant association was observed between the serum low-density lipoprotein cholesterol (LDL-C) changes and hs-CRP levels, which can justify the source of heterogeneity. CONCLUSIONS: The current study showed that statin therapy in combination with ezetimibe could be effective in reducing the levels of hs-CRP and overall CRP.

Adherence to healthy dietary pattern is associated with lower risk of multiple sclerosis.

Background: Different studies have confirmed the role of nutritional factors in the etiology of Multiple sclerosis (MS). However, dietary patterns associated with the risk of MS remain unknown. Objectives: This study aimed to investigate the possible relationship between the existing dietary patterns and the risk of MS. Methods: This case-control study was conducted in Mashhad city, Iran in 2015. In total, 197 MS patients and 200 control subjects (matched in terms of age, gender, education level, and body mass index) were enrolled in this study. The required data were collected through interviews and questionnaire completion. Moreover, the data on the usual dietary intake of each participant during the past year were evaluated using a valid and reliable semi-quantitative food frequency questionnaire (160 items). Logistic regression analysis was applied to discover the associations between dietary patterns and the risk of MS. Results: Four major dietary patterns were identified in this study, including Unhealthy, Western, Healthy, and Traditional. After adjustment for smoking habits, the family history of autoimmune diseases and the duration of breastfeeding, the highest tertile of Healthy dietary pattern was found to be associated with the reduced risk of MS by 74% (OR = .26; P < .001), whereas the Unhealthy dietary pattern was associated with a three-fold increased risk of MS (OR = 3.04; P < .001). However, no correlation was observed between the Western and Traditional dietary patterns and the risk of MS. Conclusion: According to the results of this study, a healthy diet may reduce the risk of MS, whereas an unhealthy dietary pattern may.