Tang Quen Oak, Tran Gui Tong, Gamie Zakareya, Graham Simon, Tsialogiannis Evaggelos, Tsiridis Evgenios, Linder Tobias, Tsiridis Eleftherios
University of Leeds School of Medicine, Leeds General Infirmary Teaching Hospitals NHS Trust, Academic Department of Trauma and Orthopaedics, Leeds, LS1 3EX, UK.
Expert Opin Investig Drugs. 2008 Oct;17(10):1435-63. doi: 10.1517/13543784.17.10.1435.
Statins are 3-hydroxy-3-methylglutaryl (HMG)-CoA reductase inhibitors and have been shown to possess anti-lipidaemic properties effective in lowering cholesterol. Recent evidence has suggested beneficial pleiotropic effects, including that of fracture healing, alongside its widely accepted ability to reduce the incidence of cardiovascular disease.
A comprehensive review of the recent literature on the effect of statins on bone mineral density and fracture healing.
Medline/Ovid and EMBASE search and manual search of bibliography of key papers, on the effects of statins on bone metabolism including in vitro and in vivo studies, as well as clinical trials on the effects of statins on bone mineral density and fracture risk.
RESULTS/CONCLUSIONS: There is robust in vitro and in vivo evidence to suggest the anabolic effects of statins on bone metabolism. Although evidence in patients with osteoporosis is conflicting, several studies have shown that the use of statins is associated with increases in bone mass density and reduction in fracture risk. Conflicting studies identified may be due to different routes of administration, types of statins employed and low doses used. Taken together, there is strong evidence to suggest that statins have beneficial effects on fracture healing that would support further clinical trials investigating such properties.
他汀类药物是3-羟基-3-甲基戊二酰辅酶A（HMG）还原酶抑制剂，已被证明具有降低胆固醇的抗血脂特性。最近的证据表明，除了其被广泛认可的降低心血管疾病发病率的能力外，它还具有有益的多效性作用，包括对骨折愈合的作用。
全面综述近期关于他汀类药物对骨密度和骨折愈合影响的文献。
通过Medline/Ovid和EMBASE进行检索，并人工检索关键论文的参考文献，内容涉及他汀类药物对骨代谢的影响，包括体外和体内研究，以及他汀类药物对骨密度和骨折风险影响的临床试验。
结果/结论：有充分的体外和体内证据表明他汀类药物对骨代谢具有合成代谢作用。尽管在骨质疏松症患者中的证据存在矛盾，但多项研究表明，使用他汀类药物与骨密度增加和骨折风险降低有关。所发现的相互矛盾的研究可能是由于给药途径不同、使用的他汀类药物类型以及使用的低剂量所致。综合来看，有强有力的证据表明他汀类药物对骨折愈合具有有益作用，这将支持进一步研究此类特性的临床试验。
