Manoj K, Jain N, Madhu S V
Department of Endocrinology, Centre for Diabetes Endocrinology and Metabolism, University College of Medical Sciences (University of Delhi)and GTB Hospital, New Delhi, India.
Indian J Endocrinol Metab. 2017 Jul-Aug;21(4):504-509. doi: 10.4103/ijem.IJEM_79_17.
This study aims to investigate the prevalence and risk factors of statin-induced myopathy.
A total of 200 patients aged ≥ 40 years and taking atorvastatin 10 mg/day or more for at least 2 weeks were recruited in the study. A detailed history of participants and anthropometry of study participants was recorded, and features of myopathy were explained. Biochemical investigations along with thyroid stimulating hormone (TSH) and Vitamin D were done in all patients.
Mean age of study population was 54.81 ± 9.10 years. Sixty-five percent (65.5%) of atorvastatin users had coronary heart disease, 62.5% were hypertensive, 38% had diabetes. Thirty-five percent (35.5%) patients were taking 10 mg/day atorvastatin, 45% were taking 20 mg/day, and 19.5% were taking 40 mg/day. The overall frequency of myopathy among statin users was 7.5% which was significantly higher with increasing dose of atorvastatin (1.4% in 10 mg/day group, 10% in 20 mg/day group, and 12.8% in 40 mg/day, < 0.05). The frequency of atorvastatin-related myopathy was higher in females 8.65% compared to 6.25% in males. Serum TSH levels in patients with myopathy were 4.05 ± 7.76 μIU/ml while in those without myopathy were 3.13 ± 2.88 μIU/ml ( = 0.649). Serum 25-hydroxy Vitamin D levels were measured in 66 patients randomly. Mean levels in patients with myopathy were 15.98 ± 12.94 ng/ml and without myopathy were 10.20 ± 5.64 ng/ml ( = 0.285).
The present study demonstrates that a significantly higher number of patients taking atorvastatin develop myopathy in real life clinical condition. The frequency of myopathy increases with increase in atorvastatin dose.
本研究旨在调查他汀类药物引起的肌病的患病率及危险因素。
本研究共纳入200例年龄≥40岁且服用阿托伐他汀10毫克/天及以上至少2周的患者。记录参与者的详细病史及人体测量数据，并对肌病特征进行说明。对所有患者进行生化检查以及促甲状腺激素（TSH）和维生素D检测。
研究人群的平均年龄为54.81±9.10岁。65.5%的阿托伐他汀使用者患有冠心病，62.5%患有高血压，38%患有糖尿病。35.5%的患者服用10毫克/天的阿托伐他汀，45%服用20毫克/天，19.5%服用40毫克/天。他汀类药物使用者中肌病的总体发生率为7.5%，且随着阿托伐他汀剂量的增加显著升高（10毫克/天组为1.4%，20毫克/天组为10%，40毫克/天组为12.8%，P<0.05）。阿托伐他汀相关肌病的发生率女性为8.65%，高于男性的6.25%。肌病患者的血清TSH水平为4.05±7.76微国际单位/毫升，而无肌病患者的血清TSH水平为3.13±2.88微国际单位/毫升（P=0.649）。随机选取66例患者检测血清25-羟维生素D水平。肌病患者的平均水平为15.98±12.94纳克/毫升，无肌病患者的平均水平为10.20±5.64纳克/毫升（P=0.285）。
本研究表明，在现实临床情况下，服用阿托伐他汀的患者发生肌病的人数显著更多。肌病的发生率随阿托伐他汀剂量的增加而升高。
