Peeters Geeske, Tett Susan E, Conaghan Philip G, Mishra Gita D, Dobson Annette J
The University of Queensland, Brisbane, Queensland, Australia.
Arthritis Care Res (Hoboken). 2015 Jan;67(1):13-20. doi: 10.1002/acr.22389.
Previous studies have suggested that statins may prevent development of osteoarthritis and have antiinflammatory effects. Our aim was to examine the associations between statin use and patient-reported joint symptoms in 2 large cohorts of middle-aged and older women.
Data were from 6,966 middle-aged (born 1946-1951) and 4,806 older (born 1921-1926) participants in the Australian Longitudinal Study on Women's Health who completed surveys from 2001 to 2011, including questions about joint pain/stiffness, physical functioning, and self-rated health (SRH). Administrative pharmaceutical data were used to classify participants according to statin use, cumulative volume of statin use, and type of drug. Associations between statin use and newly reported symptoms were analyzed using logistic regression with generalized estimating equations to account for repeated measures.
A total of 2,096 (31.3%) of the middle-aged women and 2,473 (51.5%) of the older women were classified as statin users. After adjustment for confounders, statin use in middle-aged women was weakly associated with poor physical functioning (odds ratio [OR] 1.29, 99% confidence interval [99% CI] 1.07-1.55) and poor SRH (OR 1.35, 99% CI 1.13-1.61), but not with new joint pain/stiffness (OR 1.09, 99% CI 0.88-1.34). No dose-response relationships were found. Pravastatin and atorvastatin were associated with poor physical functioning, while atorvastatin was also associated with poor SRH. Associations found in older women were mostly explained by confounders.
This large study did not demonstrate an association between statin use and reduced onset of joint pain/stiffness. Associations between statin use and poor physical functioning and poor SRH may be explained by factors other than joint pain/stiffness, e.g., muscle pain.
既往研究表明他汀类药物可能预防骨关节炎的发生并具有抗炎作用。我们的目的是在2个大型中老年女性队列中研究他汀类药物使用与患者报告的关节症状之间的关联。
数据来自澳大利亚女性健康纵向研究中6966名中年（出生于1946 - 1951年）和4806名老年（出生于1921 - 1926年）参与者，她们完成了2001年至2011年的调查，包括有关关节疼痛/僵硬、身体功能和自评健康（SRH）的问题。利用行政药学数据根据他汀类药物使用情况、他汀类药物使用累积量和药物类型对参与者进行分类。使用广义估计方程的逻辑回归分析他汀类药物使用与新报告症状之间的关联，以考虑重复测量。
共有2096名（31.3%）中年女性和2473名（51.5%）老年女性被归类为他汀类药物使用者。在调整混杂因素后，中年女性使用他汀类药物与身体功能差（比值比[OR]1.29，99%置信区间[99%CI]1.07 - 1.55）和自评健康差（OR 1.35，99%CI 1.13 - 1.61）弱相关，但与新的关节疼痛/僵硬无关（OR 1.09，99%CI 0.88 - 1.34）。未发现剂量反应关系。普伐他汀和阿托伐他汀与身体功能差相关，而阿托伐他汀也与自评健康差相关。在老年女性中发现的关联大多由混杂因素解释。
这项大型研究未证明他汀类药物使用与关节疼痛/僵硬发作减少之间存在关联。他汀类药物使用与身体功能差和自评健康差之间的关联可能由关节疼痛/僵硬以外的因素解释，例如肌肉疼痛。
