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他汀类药物使用与骨质流失的关系:一项基于人群的绝经后早期女性前瞻性队列研究。

Relation of statin use and bone loss: a prospective population-based cohort study in early postmenopausal women.

作者信息

Sirola J, Sirola J, Honkanen R, Kröger H, Jurvelin J S, Mäenpää P, Saarikoski S

机构信息

University of Kuopio, Research Institute of Public Health, Finland.

出版信息

Osteoporos Int. 2002 Jul;13(7):537-41. doi: 10.1007/s001980200070.

Abstract

Recent experimental and epidemiologic studies have suggested that the lipid-lowering drugs, statins, may have bone-protective effects. We studied the effects of statin use on the change in bone mineral density (BMD) in a prospective 4.5-year cohort study based on subjects from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) Study, Finland. Six hundred and twenty women aged 53-64 years were divided into four groups: 55 women reported continuous and 63 women occasional statin use during the follow-up; 142 non-users of statins reported hypercholesterolemia whereas 360 non-users did not. Spinal and femoral BMDs were measured by dual-energy X-ray densitometry in 1995-1996 and 1999-2000 and the BMD changes of the four groups were compared. Characteristics of the study population were obtained with postal inquiries. The mean annual spinal and femoral BMD changes of the study groups were 0.29% and -0.50% for the continuous statin users, 0.19% and -0.57% for the occasional statin users, 0.52% and -0.29% for the hypercholesterolemic non-users of statins, and 0.39% and -0.33% for the non-users of statins without hypercholesterolemia, ( p = 0.398 and p = 0.404) respectively. The corresponding BMD changes adjusted for age, years since menopause, body mass index, BMD at baseline, calcium intake, estrogen and cortisone therapy, duration of follow-up and statin use before the baseline were -0.20% and -0.47%, 0.19% and -0.54%, 0.54% and -0.32%, 0.47% and -0.33% ( p = 0.134 and p = 0.628), respectively. Our results suggest that statins do not protect from early postmenopausal bone loss. Randomized trials are needed to confirm these results.

摘要

近期的实验和流行病学研究表明,降血脂药物他汀类药物可能具有保护骨骼的作用。我们在一项基于芬兰库奥皮奥骨质疏松症危险因素与预防(OSTPRE)研究受试者的前瞻性4.5年队列研究中,研究了他汀类药物的使用对骨密度(BMD)变化的影响。620名年龄在53 - 64岁的女性被分为四组:55名女性报告在随访期间持续使用他汀类药物,63名女性偶尔使用;142名未使用他汀类药物的人报告患有高胆固醇血症,而360名未使用者则没有。在1995 - 1996年和1999 - 2000年通过双能X线骨密度仪测量脊柱和股骨的骨密度,并比较四组的骨密度变化。通过邮政询问获取研究人群的特征。持续使用他汀类药物的研究组脊柱和股骨骨密度的年均变化分别为0.29%和 - 0.50%,偶尔使用他汀类药物的研究组为0.19%和 - 0.57%,患有高胆固醇血症的未使用他汀类药物者为0.52%和 - 0.29%,未患高胆固醇血症的未使用他汀类药物者为0.39%和 - 0.33%,(p = 0.398和p = 0.404)。根据年龄、绝经后年限、体重指数、基线骨密度、钙摄入量、雌激素和皮质醇治疗、随访时间以及基线前他汀类药物使用情况调整后的相应骨密度变化分别为 - 0.20%和 - 0.47%,0.19%和 - 0.54%,0.54%和 - 0.32%,0.47%和 - 0.33%(p = 0.134和p = 0.628)。我们的结果表明,他汀类药物不能预防绝经后早期骨质流失。需要进行随机试验来证实这些结果。

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