Effect of ABCG2 c.421 C> A (rs2231142) single nucleotide polymorphisms on the lipid-modulating efficacy of rosuvastatin: a meta-analysis

Background To systematically evaluate the effect of ABCG2 c.421 C > A (rs2231142) single nucleotide polymorphism (SNP) on the lipid-modulating efficacy of rosuvastatin (RST). Methods Searches were conducted using the Wan Fang database, Web of Science, Embase, PubMed, Cochrane Library, and China Journal Full Text Database. The time frame for the search was from the database's creation to September 1, 2024. The RevMan 5.4 software was used to conduct a meta-analysis after the literature was filtered based on the inclusion and exclusion criteria, and pertinent data was extracted following methodological quality evaluation. Results A total of 7 studies, including 1347 patients, were included. Meta-analysis showed that in a dominant model of inheritance, RST had a significant effect on low-density lipoprotein cholesterol (LDL-C) [MD = -7.23, 95% CI (-8.71, -5.75), P < 0.05], total cholesterol (TC) [MD = -7.15, 95% CI (-8.71, -5.75), P < 0.05], and triglyceride (TG) [MD = -7.34, 95% CI (-10.88, -3.80), P < 0.05] in patients harboring an A allele decreased significantly more than CC, but there was no significant difference in the change of high-density lipoprotein cholesterol (HDL-C) [MD = -2.22, 95% CI (-19.87, 15.43), P = 0.81]. The results of the sensitivity analysis suggested that all outcome indicators were stable. However, this study's small sample size may be heterogeneous, and more large-sample, multi-center studies are needed for future validation. Conclusions The ABCG2 c.421 C > A (rs2231142) SNP significantly affected the lipid-modulating efficacy of RST, especially the down-regulation of LDL-C, TC, and TG.