Bischoff-Ferrari Heike A, Fischer Karina, Orav Endel J, Dawson-Hughes Bess, Meyer Ursina, Chocano-Bedoya Patricia O, Meyer Otto W, Ernst Rahel, Schietzel Simeon, Eberli Franz, Staehelin Hannes B, Freystätter Gregor, Roas Susanne, Theiler Robert, Egli Andreas, Wilson Nicholas M
Department of Geriatrics and Aging Research, University Hospital Zurich, Zurich, Switzerland.
Centre on Aging and Mobility, University of Zurich and City Hospital Waid, Zurich, Switzerland.
J Am Geriatr Soc. 2017 Jun;65(6):1267-1273. doi: 10.1111/jgs.14784. Epub 2017 Feb 27.
To determine whether statin use alters response of 25-hydroxyvitamin D (25(OH)D) level to vitamin D treatment.
Pooled analysis.
Three double-blind randomized controlled trials that tested different doses of vitamin D.
Participants of three trials (N = 646; mean age 76.3 ± 8.4, 65% female).
In all three trials, 25(OH)D status and statin use were assessed repeatedly over time (baseline, 6 and 12 months). Repeated-measures analysis was used to compare 25(OH)D response to vitamin D treatment at baseline and 6 and 12 months of statin users and nonusers, controlling for age, sex, body mass index, Charlson Comorbidity Index, vitamin D dose, trial, and season.
At baseline, 17.5% were statin users, and 65% were vitamin D deficient (25(OH)D < 20 ng/mL). Baseline 25(OH)D levels did not differ significantly between groups at baseline (18.8 for statin users, 17.2 ng/mL for nonusers, P = .07), but according to the longitudinal analyses, the total increase over 12 months in 25(OH)D concentration was significantly lower in statin users (13.1 ng/L) than nonusers (15.9 ng/mL; 21.4% difference; P = .009).
Of persons aged 60 and older at high risk of vitamin D deficiency, statin users had a 21.4% smaller increase in 25(OH)D serum concentrations over time than nonusers, independent of vitamin D dose and other covariates.
确定使用他汀类药物是否会改变25-羟维生素D(25(OH)D)水平对维生素D治疗的反应。
汇总分析。
三项测试不同剂量维生素D的双盲随机对照试验。
三项试验的参与者(N = 646;平均年龄76.3±8.4岁,65%为女性)。
在所有三项试验中,随时间(基线、6个月和12个月)反复评估25(OH)D状态和他汀类药物使用情况。采用重复测量分析比较他汀类药物使用者和非使用者在基线、6个月和12个月时25(OH)D对维生素D治疗的反应,并对年龄、性别、体重指数、Charlson合并症指数、维生素D剂量、试验和季节进行控制。
在基线时,17.5%的人使用他汀类药物,65%的人维生素D缺乏(25(OH)D<20 ng/mL)。两组在基线时的25(OH)D水平无显著差异(他汀类药物使用者为18.8,非使用者为17.2 ng/mL,P = 0.07),但根据纵向分析,他汀类药物使用者在12个月内25(OH)D浓度的总增加量(13.1 ng/L)显著低于非使用者(15.9 ng/mL;差异21.4%;P = 0.009)。
在60岁及以上维生素D缺乏高危人群中,他汀类药物使用者随时间推移25(OH)D血清浓度的增加量比非使用者小21.4%,与维生素D剂量和其他协变量无关。