Bonfim Mariana Rotta, Oliveira Acary Souza Bulle, do Amaral Sandra Lia, Monteiro Henrique Luiz
Programa de Pós-Graduação em Ciências da Motricidade, Instituto de Biociências, Universidade Estadual Paulista, Rio Claro, SP, Brazil.
Setor de Doenças Neuromusculares, Escola Paulista de Medicina, Universidade Federal de São Paulo, Bauru, SP, Brazil.
Arq Bras Cardiol. 2015 Apr;104(4):324-31. doi: 10.5935/abc.20150005. Epub 2015 Feb 13.
Statin treatment in association with physical exercise practice can substantially reduce cardiovascular mortality risk of dyslipidemic individuals, but this practice is associated with myopathic event exacerbation. This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords "statin" AND "exercise" AND "muscle", restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises. Moderate physical training, in turn, when associated to statins does not increase creatine kinase levels or pain reports, but improves muscle and metabolic functions as a consequence of training. Therefore, it is suggested that dyslipidemic patients undergoing statin treatment should be exposed to moderate aerobic training in combination to resistance exercises three times a week, and the provision of physical training prior to drug administration is desirable, whenever possible.
他汀类药物治疗联合体育锻炼可大幅降低血脂异常患者的心血管疾病死亡风险,但这种联合治疗与肌病事件的恶化有关。本研究旨在展示有关他汀类药物及其与体育锻炼对骨骼肌影响的特定文献的最新结果。因此,通过在PubMed和SciELO数据库中使用关键词“他汀类药物”、“运动”和“肌肉”进行组合检索,将文献选择限制在1990年1月至2013年11月发表的原始研究,进行了一项文献综述。分析了16项评估他汀类药物联合急性或慢性运动对骨骼肌影响的研究。研究结果表明,使用他汀类药物的运动员可能会对骨骼肌产生有害影响,因为在高强度训练或急性离心和剧烈运动时,骨骼肌损伤的恶化更为频繁。相反,适度的体育锻炼与他汀类药物联合使用时,不会增加肌酸激酶水平或疼痛报告,但由于锻炼可改善肌肉和代谢功能。因此,建议接受他汀类药物治疗的血脂异常患者应每周进行三次适度的有氧运动并结合抗阻运动,并且只要有可能,在给药前进行体育锻炼是可取的。