Effect of HMG-CoA reductase inhibitors (statins) on bone mineral density
Effect of HMG-CoA reductase inhibitors (statins) on bone mineral density
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DOI：
10.1385/jcd:5:2:151
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发表时间：
2002-06-01
影响因子：
2.5
通讯作者：
Adler, RA
中科院分区：
文献类型：
--
作者：
Funkhouser, HL;Adera, T;Adler, RA
最近的研究表明，3-羟基-3-甲基戊二酰辅酶A（HMG-CoA）还原酶抑制剂（他汀类药物）可以增加骨密度（BMD）。我们的目的是确定使用他汀类药物的患者是否比未使用这些药物的患者更有可能具有更高的骨密度和更低的骨质疏松症风险。计算机化药房系统为983名患者（697名男性和286名女性）提供了完整的药物分配记录，这些患者在一个退伍军人事务医疗中心接受骨密度测试。在协方差模型分析中，调整了年龄、体重指数、种族和维生素的使用，使用他汀类药物的男性更可能有更大的脊柱BMD（p < 0.005）。平均差异（效应量）为0.05 g/cm（2）（95%置信区间[CL] 0.02-0.09），BMD增加约5.3%。在女性中，这种关联并不显著。在调整潜在混杂变量后，使用逻辑回归分析确定骨质疏松症的风险（定义为T评分< -2.5）。虽然没有统计学意义，但接受他汀类药物超过2年的男性患骨质疏松症的可能性约为一半（比值比[OR] = 0.55，95%CI = 0.28-1.08）。在服用他汀类药物任何时间长度的女性中观察到类似的效果（OR = 0.36，95%CI = 0.12-1.07）。这项研究表明，他汀类药物可能会降低骨质疏松症的风险，这是一项随机对照试验。
Recent studies have suggested that 3-hydroxy-3-methylglutaryl - coenzyme A (HMG-CoA) reductase inhibitors (statins) can increase the bone mineral density (BMD). Our objective was to determine if patients on statin drugs were more likely to have a greater bone mineral density and lower risk of osteoporosis than patients not taking these drugs. A computerized pharmacy system provided complete medication dispensing records for the 983 patients (697 men and 286 women) referred for bone mineral density testing at a single Veterans Affairs Medical Center. In an analysis of covariance model that adjusted for age, body mass index, race, and vitamin use, men using statin drugs were more likely to have a greater BMD of the spine (p < 0.005). The mean difference (effect size) was 0.05 g/cm(2) (95% confidence interval of [CL] 0.02-0.09), about 5.3% greater BMD. In women, the association was not significant. The risk of osteoporosis (defined as a T-score < -2.5) was determined using logistic regression analysis after adjustment for potential confounding variables. Although not statistically significant, men who received statin drugs for more than 2 yr were approximately half as likely to develop osteoporosis (odds ratio [OR] =.55, 95% Cl = 0.28-1.08). A similar effect was observed in women taking statins for any length of time (OR = 0.36, 95% CI = 0.12-1.07). This study suggests that statin drugs may decrease osteoporosis risk, warranting a randomized controlled trial.