Hernández José L, Olmos José M, Romaña Galo, Llorca Javier, Martínez Josefina, Castillo Jesús, de Juan Julia, Pérez-Pajares Isabel, Ruiz Sheila, González-Macías Jesús
Bone Metabolic Unit (J.L.H., J.M.O., J.M., S.R., J.G.-M.), Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla, University of Cantabria, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad, and Epidemiology Unit (J.L.), Medical School, University of Cantabria, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, 39008 Santander, Spain; and Centro de Salud Camargo (G.R., J.C., J.d.J., I.P.-P.), 39600 Santander, Spain.
J Clin Endocrinol Metab. 2014 Sep;99(9):3304-9. doi: 10.1210/jc.2014-1102. Epub 2014 May 30.
This study sought to assess whether the association between statin use and bone mineral density (BMD) and bone turnover markers is modulated by serum 25-hydroxyvitamin D (25OHD) levels in postmenopausal women. Design, Participants, and Settings: Approximately 1422 postmenopausal women were recruited from the Camargo Cohort after excluding those with any known medical disorder or drug that might affect bone metabolism. Participants were categorized into four groups: 25OHD levels of 20 ng/mL or less and not taking statins (group 1; n = 492); 25OHD levels greater than 20 ng/mL and on statins (group 2; n = 143); 25OHD levels of 20 ng/mL or less and using statins (group 3; n = 112); and 2OHD levels greater than 20 ng/mL and non-statin use (group 4; n = 675). Multivariate analyses were performed to compare BMD and bone turnover markers between groups.
Women in group 2 had an adjusted femoral neck and total hip BMD higher than women in group 1 (P < .0001 and P = .003, respectively). A trend toward a significant difference was observed regarding lumbar BMD (P = .08). Serum aminoterminal propeptide of type 1 collagen and C-terminal telopeptide of type 1 collagen levels were lower in group 2 than in group 1, in crude and adjusted models, although only serum C-terminal telopeptide of type 1 collagen difference was significant (P = .009).
Women on statins and serum 25OHD levels above 20 ng/mL have greater BMD and less bone resorption than those without either of the factors. Differences, however, are not significant in women with only one of them. Vitamin D and statins seem to interact positively in their effects on bone metabolism.
本研究旨在评估绝经后女性中他汀类药物使用与骨矿物质密度（BMD）及骨转换标志物之间的关联是否受血清25-羟维生素D（25OHD）水平的调节。设计、参与者及研究背景：在排除患有任何可能影响骨代谢的已知疾病或正在服用可能影响骨代谢药物的女性后，从卡马戈队列中招募了约1422名绝经后女性。参与者被分为四组：25OHD水平为20 ng/mL或更低且未服用他汀类药物（第1组；n = 492）；25OHD水平高于20 ng/mL且正在服用他汀类药物（第2组；n = 143）；25OHD水平为20 ng/mL或更低且正在使用他汀类药物（第3组；n = 112）；以及25OHD水平高于20 ng/mL且未使用他汀类药物（第4组；n = 675）。进行多变量分析以比较各组之间的BMD和骨转换标志物。
第2组女性经调整后的股骨颈和全髋部BMD高于第1组女性（分别为P <.0001和P =.003）。观察到腰椎BMD有显著差异的趋势（P =.08）。在粗模型和调整模型中，第2组的血清1型胶原氨基端前肽和1型胶原羧基端肽水平均低于第1组，尽管只有血清1型胶原羧基端肽差异具有统计学意义（P =.009）。
服用他汀类药物且血清25OHD水平高于20 ng/mL的女性比不具备这两个因素的女性具有更高的BMD和更低的骨吸收。然而，仅具备其中一个因素的女性差异不显著。维生素D和他汀类药物在对骨代谢的影响上似乎存在积极的相互作用。
