Bahls Martin, Groß Stefan, Ittermann Till, Busch Raila, Gläser Sven, Ewert Ralf, Völzke Henry, Felix Stephan B, Dörr Marcus
University Medicine Greifswald, Department of Internal Medicine B, Greifswald, Germany.
DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany.
PLoS One. 2017 Jun 15;12(6):e0179534. doi: 10.1371/journal.pone.0179534. eCollection 2017.
Exercise and statins reduce cardiovascular disease (CVD). Exercise capacity may be assessed using cardiopulmonary exercise testing (CPET). Whether statin medication is associated with CPET parameters is unclear. We investigated if statins are related with exercise capacity during CPET in the general population.
Cross-sectional data of two independent cohorts of the Study of Health in Pomerania (SHIP) were merged (n = 3,500; 50% males). Oxygen consumption (VO2) at peak exercise (VO2peak) and anaerobic threshold (VO2@AT) was assessed during symptom-limited CPET. Two linear regression models related VO2peak with statin usage were calculated. Model 1 adjusted for age, sex, previous myocardial infarction, and physical inactivity and model 2 additionally for body mass index, smoking, hypertension, diabetes and estimated glomerular filtration rate. Propensity score matching was used for validation.
Statin usage was associated with lower VO2peak (no statin: 2336; 95%-confidence interval [CI]: 2287-2,385 vs. statin 2090; 95%-CI: 2,031-2149 ml/min; P < .0001) and VO2@AT (no statin: 1,172; 95%-CI: 1,142-1,202 vs. statin: 1,111; 95%-CI: 1,075-1,147 ml/min; P = .0061) in males but not females (VO2peak: no statin: 1,467; 95%-CI: 1,417-1,517 vs. statin: 1,503; 95%-CI: 1,426-1,579 ml/min; P = 1.00 and VO2@AT: no statin: 854; 95%-CI: 824-885 vs. statin 864; 95%-CI: 817-911 ml/min; P = 1.00). Model 2 revealed similar results. Propensity scores analysis confirmed the results.
In the general population present statin medication was related with impaired exercise capacity in males but not females. Sex specific effects of statins on cardiopulmonary exercise capacity deserve further research.
运动和他汀类药物可降低心血管疾病(CVD)风险。运动能力可通过心肺运动试验(CPET)进行评估。他汀类药物治疗与CPET参数之间的关系尚不清楚。我们调查了他汀类药物是否与普通人群CPET期间的运动能力相关。
合并了波美拉尼亚健康研究(SHIP)两个独立队列的横断面数据(n = 3500;50%为男性)。在症状限制的CPET期间评估峰值运动时的耗氧量(VO2)(VO2peak)和无氧阈(VO2@AT)。计算了两个将VO2peak与他汀类药物使用情况相关联的线性回归模型。模型1对年龄、性别、既往心肌梗死和身体活动不足进行了校正,模型2还对体重指数、吸烟、高血压、糖尿病和估计肾小球滤过率进行了校正。采用倾向评分匹配进行验证。
在男性中,使用他汀类药物与较低的VO2peak(未使用他汀类药物:2336;95%置信区间[CI]:2287 - 2385 vs. 使用他汀类药物:2090;95%CI:2031 - 2149 ml/min;P <.0001)和VO2@AT(未使用他汀类药物:1172;95%CI:1142 - 1202 vs. 使用他汀类药物:1111;95%CI:1075 - 1147 ml/min;P =.0061)相关,但在女性中无此关联(VO2peak:未使用他汀类药物:1467;95%CI:1417 - 1517 vs. 使用他汀类药物:1503;95%CI:1426 - 1579 ml/min;P = 1.00;VO2@AT:未使用他汀类药物:854;95%CI:824 - 885 vs. 使用他汀类药物:864;95%CI:817 - 911 ml/min;P = 1.00)。模型2得出了类似结果。倾向评分分析证实了这些结果。
在普通人群中,目前使用他汀类药物与男性运动能力受损相关,但与女性无关。他汀类药物对心肺运动能力的性别特异性影响值得进一步研究。