Eisen Alon, Lev Eli, Iakobishvilli Zaza, Porter Avital, Brosh David, Hasdai David, Mager Aviv
Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
Isr Med Assoc J. 2014 Jan;16(1):42-5.
Treatment with HMG-CoA reductase inhibitors (statins) is often complicated by muscle-related adverse effects (MAEs). Studies of the association between low plasma vitamin D levels and MAEs have yielded conflicting results.
To determine if low plasma vitamin D level is a risk factorfor MAEs in statin users.
Plasma levels of 25(OH) vitamin D were measured as part of the routine evaluation of unselected statin-treated patients attending the coronary and lipid clinics at our hospital during the period 2007-2010. Medical data on muscle complaints and statin use were retrieved from the medical files. Creatine kinase (CK) levels were derived from the hospital laboratory database.
The sample included 272 patients (141 men) aged 33-89 years. Mean vitamin D level was 48.04 nmol/L. Levels were higher in men (51.0 +/- 20.5 versus 44.7 +/- 18.9 nmol/L, P = 0.001) and were unaffected by age. MAEs were observed in 106 patients (39%): myalgia in 95 (35%) and CK elevation in 20 (7%); 9 patients (3%) had both. There was no difference in plasma vitamin D levels between patients with and without myalgia (46.3 +/- 17.7 versus 48.9 +/- 21.0 nmol/L, P = 0.31), with and without CK elevation (50.2 +/- 14.6 versus 47.8 +/- 20.3 nmol/L, P = 0.60), or with or without any MAE (50.4 +/- 15.0 versus 47.8 +/- 10.2 nmol/L, P = 0.27). These findings were consistent when analyzed by patient gender and presence/absence of coronary artery disease, and when using a lower vitamin D cutoff (< 25 nmol/L).
There is apparently no relationship between plasma vitamin D level and risk of MAEs in statin users.
使用HMG-CoA还原酶抑制剂（他汀类药物）进行治疗时，常因肌肉相关不良反应（MAEs）而变得复杂。关于低血浆维生素D水平与MAEs之间关联的研究结果相互矛盾。
确定低血浆维生素D水平是否是他汀类药物使用者发生MAEs的危险因素。
在2007年至2010年期间，对我院冠心病和血脂门诊接受他汀类药物治疗的未选择患者进行常规评估时，检测了血浆25(OH)维生素D水平。从医疗档案中检索有关肌肉不适和他汀类药物使用的医疗数据。肌酸激酶（CK）水平来自医院实验室数据库。
样本包括272名年龄在33至89岁之间的患者（141名男性）。维生素D平均水平为48.04 nmol/L。男性的水平较高（51.0±20.5对44.7±18.9 nmol/L，P = 0.001），且不受年龄影响。106名患者（39%）出现MAEs：95名（35%）出现肌痛，20名（7%）出现CK升高；9名患者（3%）两者都有。有肌痛和无肌痛的患者之间血浆维生素D水平无差异（46.3±17.7对48.9±21.0 nmol/L，P = 0.31），有CK升高和无CK升高的患者之间无差异（50.2±14.6对47.8±20.3 nmol/L），有或无任何MAE的患者之间也无差异（50.4±15.0对47.8±10.2 nmol/L，P = 0.27）。当按患者性别和是否存在冠状动脉疾病进行分析，以及使用较低的维生素D临界值（< 25 nmol/L）时，这些结果是一致的。
在他汀类药物使用者中，血浆维生素D水平与MAEs风险之间显然没有关系。
