Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, The Netherlands.
Curr Med Res Opin. 2012 Jul;28(7):1247-52. doi: 10.1185/03007995.2012.702102. Epub 2012 Jun 28.
The mechanism of statin-related myopathy is unknown, while its prevalence is probably underestimated. An association between statin-related myopathy and vitamin D deficiency has been reported. In this pilot study we assessed the prevalence of myopathy in statin users attending the outpatient clinic of the Department of Cardiology of a University Hospital from October 2009 to March 2010. We also searched for predictors of myopathy and investigated whether the myopathy was associated with vitamin D deficiency.
Statin-treated patients were asked to complete an assisted structured questionnaire. Serum creatine kinase (CK) and 25-hydroxyvitamin D (25(OH)D) were measured. Patients with rheumatic diseases, muscle diseases, (poly)neuropathy and peripheral arterial disease were excluded from predictor analysis.
Percentage of patients with myopathy in the daily clinical practice of an outpatient clinic, serum 25(OH)D, CK, and predictors of myopathy.
One hundred and four statin-treated patients completed the questionnaire. Serum 25(OH)D was measured in 93 patients. Twenty patients with confounding comorbidities were excluded from analysis. Of the remaining 84 patients, 33% reported myopathy, 24% had myalgia and 6% myositis. Rhabdomyolysis was not observed. Time spent outdoors during winter (≤6 h/week; OR: 10.61; 95% CI: 1.91-58.88), total number of prescribed drugs (1.39; 1.05-1.83), BMI (1.35; 1.07-1.69), CK (1.02; 1.00-1.03) and consumption of fish (≥1/week; 0.19; 0.04-0.89) were predictors of myopathy in multivariate analysis.
Considering the small patient group and a relatively narrow range of vitamin D levels, we arrive at the following statements: 1) one out of three patients reported myopathy; 2) BMI, CK, number of prescription drugs, time spent outdoors and fish consumption were myopathy predictors; and 3) myopathy and 25(OH)D were unrelated.
他汀类药物相关肌病的发病机制尚不清楚，但其发病率可能被低估。他汀类药物相关肌病与维生素 D 缺乏之间存在关联。在这项初步研究中，我们评估了 2009 年 10 月至 2010 年 3 月期间在某大学医院心内科门诊接受他汀类药物治疗的患者中肌病的患病率。我们还寻找了肌病的预测因子，并研究了肌病是否与维生素 D 缺乏有关。
要求接受他汀类药物治疗的患者填写一份辅助结构化问卷。测量血清肌酸激酶（CK）和 25-羟维生素 D（25(OH)D）。将患有风湿性疾病、肌肉疾病、（多）神经病和外周动脉疾病的患者排除在预测因子分析之外。
门诊日常临床实践中肌病患者的百分比、血清 25(OH)D、CK 和肌病的预测因子。
104 名接受他汀类药物治疗的患者完成了问卷。93 名患者测量了血清 25(OH)D。20 名存在混杂合并症的患者被排除在分析之外。在剩余的 84 名患者中，33%报告有肌病，24%有肌痛，6%有肌炎。未观察到横纹肌溶解症。冬季户外活动时间（≤6 小时/周；OR：10.61；95%CI：1.91-58.88）、开处方药物总数（1.39；1.05-1.83）、BMI（1.35；1.07-1.69）、CK（1.02；1.00-1.03）和鱼的食用量（≥1/周；0.19；0.04-0.89）是多变量分析中肌病的预测因子。
考虑到患者人数较少且维生素 D 水平范围较窄，我们得出以下结论：1）三分之一的患者报告有肌病；2）BMI、CK、处方药物数量、户外活动时间和鱼类食用量是肌病的预测因子；3）肌病与 25(OH)D 无关。
