Effects of randomized rosuvastatin compared with placebo on bone and body composition among HIV-infected adults.
Effects of randomized rosuvastatin compared with placebo on bone and body composition among HIV-infected adults.
复制标题
DOI：
10.1097/qad.0000000000000526
复制
发表时间：
2015-01-14
期刊：
影响因子：
--
通讯作者：
McComsey GA
中科院分区：
文献类型：
--
作者：
Erlandson KM;Jiang Y;Debanne SM;McComsey GA
Statins have a beneficial effect on bone mineral density (BMD) and lean mass in some studies of HIV-uninfected adults, however this has never been investigated in the setting of HIV infection. HIV-infected subjects on stable antiretroviral therapy with a low-density lipoprotein cholesterol level of ≤ 130 mg/dL and evidence of heightened immune activation or inflammation were randomized to rosuvastatin 10mg daily or placebo for 96 weeks. This was a prespecified interim analysis at 48 weeks. Between-group and within group differences were compared; multivariable regression models were constructed. 72 subjects were randomized to statin therapy and 75 to placebo. Modest 48 week relative increases in trochanter BMD (0.9%; 95% CI: -0.9, 0.6%) and total hip BMD (0.6%; 95% CI: 0.0, 1.1%) in the statin arm were significantly greater than placebo (p<0.05). The relationship between statin use and total hip BMD change was robust to adjustment of age, gender, race, and smoking status (p=0.02) and strengthened by inclusion of baseline (p=0.01) and week 48 change in sTNFR-1 (p=0.009). Relative increases in total body, trunk and limb fat were similar between statin and placebo arms (p ≥0.58). Although a significant gain in leg lean mass was seen in the statin arm, this was not significantly different compared to placebo (p=0.36). The improvements seen in total hip BMD after 48 weeks of rosuvastatin therapy support further potential benefits of statin therapy in HIV, beyond a reduction of cardiovascular risk.
