Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland.
Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology, Medical University of Lodz, Lodz, Poland.
Trends Pharmacol Sci. 2018 Apr;39(4):331-353. doi: 10.1016/j.tips.2018.02.003. Epub 2018 Mar 1.
Some studies using small doses of statins revealed significant benefits for patients with chronic heart failure (HF). However, the results of large randomized studies did not confirm these advantages. Along with the primary effect of cholesterol lowering, statins have many ancillary actions that may be relevant for body wasting. In this context, the fear of muscle-related side effects needs to be put into clinical context and assessed appropriately before statins are either withheld or withdrawn in patients with sarcopenia (muscle wasting). Some of the mechanistic bases of statin-mediated muscle dysfunction correspond with mechanisms of sarcopenia observed in HF with reduced ejection fraction patients, connected with insulin-like growth factor 1, inflammation, the ubiquitin-proteasome pathway, apoptosis, and myostatin. Here we present the hypothesis of potential prosarcopenic properties of statins as a possible explanation of the lack of effectiveness of these drugs in HF patients.
一些使用小剂量他汀类药物的研究表明，此类药物对慢性心力衰竭（HF）患者有显著益处。然而，大型随机研究的结果并未证实这些优势。除了降低胆固醇的主要作用外，他汀类药物还有许多辅助作用，这些作用可能与身体消瘦有关。在这种情况下，在考虑是否拒绝或停止肌肉减少症（肌肉消瘦）患者使用他汀类药物之前，需要将对肌肉相关副作用的担忧置于临床背景下并进行适当评估。他汀类药物引起肌肉功能障碍的一些机制基础与射血分数降低的心力衰竭患者中观察到的与胰岛素样生长因子 1、炎症、泛素蛋白酶体途径、细胞凋亡和肌肉生长抑制素相关的肌肉减少症的机制相对应。在这里，我们提出他汀类药物潜在的促肌肉减少症特性的假设，这可能是这些药物在心力衰竭患者中无效的原因之一。
