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65岁及以上女性使用他汀类药物与发生衰弱的关系:来自女性健康倡议观察性研究的前瞻性结果。

Statin use and incident frailty in women aged 65 years or older: prospective findings from the Women's Health Initiative Observational Study.

作者信息

LaCroix Andrea Z, Gray Shelly L, Aragaki Aaron, Cochrane Barbara B, Newman Anne B, Kooperberg Charles L, Black Henry, Curb J David, Greenland Philip, Woods Nancy F

机构信息

Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 2008 Apr;63(4):369-75. doi: 10.1093/gerona/63.4.369.

Abstract

BACKGROUND

Inflammatory biomarkers have shown consistent associations with disability and frailty in older adults. Statin medications may reduce the incidence the frailty because of their anti-inflammatory effects. This study examines associations between current use, duration, and potency of statin medications and incident frailty in initially nonfrail women 65 years old or older.

METHODS

The authors conducted a prospective analysis of data from the Women's Health Initiative Observational Study (WHI-OS) conducted at 40 clinical centers in the United States. Eligible women were nonfrail and 65-79 years old at baseline (n = 25,378). Current statin use at baseline was ascertained through direct inspection of medicine containers during clinic visits. Frailty was ascertained through self-reported indicators and physical measurements at baseline and 3-year clinic contacts. Components of frailty included self-reported low physical function, exhaustion, low physical activity, and unintended weight loss. Multinomial logistic regression models were used to adjust for covariates predicting incident frailty.

RESULTS

Among the 25,378 eligible women, 3453 (13.6%) developed frailty by the 3-year follow-up contact. Current statin use had no association with incident frailty (multivariate-adjusted odds ratio [OR] = 1.00; 95% confidence interval [CI], 0.85-1.16). Duration and potency of statin use were also not significantly associated with incident frailty. Among low potency statin users, longer duration of use was associated with reduced risk of frailty (p for trend =.02). A similar pattern of results was observed when frailty was studied in the absence of intervening, incident cardiovascular events.

CONCLUSIONS

Overall, incidence of frailty was similar in current statin users and nonusers.

摘要

背景

炎症生物标志物已显示出与老年人的残疾和虚弱存在持续关联。他汀类药物因其抗炎作用可能会降低虚弱的发生率。本研究调查了他汀类药物的当前使用情况、使用时长和效力与65岁及以上初发非虚弱女性发生虚弱之间的关联。

方法

作者对在美国40个临床中心进行的女性健康倡议观察性研究(WHI-OS)的数据进行了前瞻性分析。符合条件的女性在基线时非虚弱且年龄在65至79岁之间(n = 25378)。通过在门诊就诊时直接检查药盒来确定基线时他汀类药物的当前使用情况。通过基线时和3年门诊随访时的自我报告指标和身体测量来确定虚弱情况。虚弱的组成部分包括自我报告的身体功能低下、疲惫、身体活动少和非故意体重减轻。使用多项逻辑回归模型对预测发生虚弱的协变量进行调整。

结果

在25378名符合条件的女性中,有3453名(13.6%)在3年随访时出现了虚弱。当前使用他汀类药物与发生虚弱无关联(多变量调整后的比值比[OR] = 1.00;95%置信区间[CI],0.85 - 1.16)。他汀类药物的使用时长和效力也与发生虚弱无显著关联。在低效他汀类药物使用者中,使用时间越长,虚弱风险降低(趋势p值 = 0.02)。在没有干预性心血管事件发生的情况下研究虚弱时,观察到了类似的结果模式。

结论

总体而言,当前使用他汀类药物者和未使用者的虚弱发生率相似。

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