Montagnani A, Gonnelli S, Cepollaro C, Pacini S, Campagna M S, Franci M B, Lucani B, Gennari C
Department of Internal Medicine, University of Siena, Italy.
Bone. 2003 Apr;32(4):427-33. doi: 10.1016/s8756-3282(03)00034-6.
Although several studies have reported a lower risk of osteoporotic fracture in hypercholesterolemic patients treated with statins, so far longitudinal studies on the effects of statins on bone are lacking. The aim of the present study was to evaluate bone mineral density (BMD) and bone turnover changes induced by 1-year simvastatin treatment on postmenopausal women. Thirty consecutive postmenopausal hypercholesterolemic women (61.2 +/- 4.9 years) were treated for 12 months with 40 mg/day simvastatin and 30 normocholesterolemic age-matched postmenopausal women provided control data. In all subjects, at baseline and at 3-month intervals, serum lipids, calcium, phosphate, total and bone alkaline phosphatase (Bone-ALP), and carboxy-terminal fragment of type I collagen (CTx) were measured in a fasting blood sample. At baseline and after 6 and 12 months BMD was measured at lumbar spine (BMD-LS) and at femur (BMD-Ftot) and at femoral neck (BMD-Fn) by DXA. In the simvastatin-treated group Bone-ALP showed a significant increase (P < 0.05) with respect to baseline from the sixth month, whereas serum CTx showed a weak and nonsignificant increase over the study period. In treated women BMD-LS, BMD-Fn, and BMD-Ftot increased respectively by 1.1, 0.9, and 0.4% at Month 6; and by 2.8, 1.0, and 0.8% at Month 12. In controls BMD-LS, BMD-Fn, and BMD-Ftot at the end of the study period decreased by 1.6, 1.4, and 1.2%, respectively. The difference between controls and simvastatin-treated patients was significant (P < 0.05) for both BMD-LS and BMD-Fn only at Month 12. In conclusion our results, although obtained from a small sample of postmenopausal hypercholesterolemic women, suggest a probable positive effect of simvastatin on bone formation and BMD.
尽管多项研究报告称，接受他汀类药物治疗的高胆固醇血症患者发生骨质疏松性骨折的风险较低，但迄今为止，关于他汀类药物对骨骼影响的纵向研究仍很缺乏。本研究的目的是评估辛伐他汀治疗1年对绝经后女性骨密度（BMD）和骨转换的影响。连续30名绝经后高胆固醇血症女性（61.2±4.9岁）接受每日40mg辛伐他汀治疗12个月，30名年龄匹配的血脂正常的绝经后女性提供对照数据。对所有受试者，在基线时以及每隔3个月，采集空腹血样测量血脂、钙、磷、总碱性磷酸酶和骨碱性磷酸酶（骨ALP）以及I型胶原羧基末端片段（CTx）。在基线时以及6个月和12个月后，通过双能X线吸收法（DXA）测量腰椎（BMD-LS）、股骨（BMD-Ftot）和股骨颈（BMD-Fn）的骨密度。在辛伐他汀治疗组中，从第6个月起骨ALP相对于基线显著升高（P<0.05），而血清CTx在研究期间呈微弱且不显著的升高。在接受治疗的女性中，第6个月时BMD-LS、BMD-Fn和BMD-Ftot分别增加了1.1%、0.9%和0.4%；第12个月时分别增加了2.8%、1.0%和0.8%。在对照组中，研究期末BMD-LS、BMD-Fn和BMD-Ftot分别下降了1.6%、1.4%和1.2%。仅在第12个月时，对照组和辛伐他汀治疗患者之间在BMD-LS和BMD-Fn方面的差异具有统计学意义（P<0.05）。总之，我们的结果虽然是从一小部分绝经后高胆固醇血症女性样本中获得的，但表明辛伐他汀对骨形成和骨密度可能具有积极作用。
