Department of Nutrition, China Medical University, Taichung 40402, Taiwan.
Department of Dietetics, Yunlin Christian Hospital, Yunlin 64866, Taiwan.
Int J Environ Res Public Health. 2020 Feb 26;17(5):1494. doi: 10.3390/ijerph17051494.
: Previous research found that statins, in addition to its efficiency in treating hyperlipidemia, may also incur adverse drug reactions, which mainly include myopathies and abnormalities in liver function. This study aims to assess the risk for newly onset sarcopenia among patients with chronic kidney disease using statins. In a nationwide retrospective population-based cohort study, 75,637 clinically confirmed cases of chronic kidney disease between 1997 and 2011were selected from the National Health Insurance Research Database of Taiwan. The selection of the chronic kidney disease cohort included a discharge diagnosis with chronic kidney disease or more than 3 outpatient visits with the diagnosis of chronic kidney disease found within 1 year. After consideration of patient exclusions, we finally got a total number of 67,001 cases of chronic kidney disease in the study. The Cox proportional hazards model was used to perform preliminary analysis on the effect of statins usage on the occurrence of newly diagnosed sarcopenia; the Cox proportional hazards model with time-dependent covariates was conducted to take into consideration the individual temporal differences in medication usage, and calculated the hazard ratio (HR) and 95% confidence interval after controlling for gender, age, income, and urbanization. Our main findings indicated that patients with chronic kidney disease who use statins seem to effectively prevent patients from occurrences of sarcopenia, high dosage of statins seem to show more significant protective effects, and the results are similar over long-term follow-up. In addition, the risk for newly diagnosed sarcopenia among patients with lipophilic statins treatment was lower than that among patients with hydrophilic statins treatment. It seems that patients with chronic kidney disease could receive statin treatment to reduce the occurrence of newly diagnosed sarcopenia. Additionally, a higher dosage of statins could reduce the incidence of newly diagnosed sarcopenia in patients with chronic kidney disease.
: 先前的研究发现，他汀类药物除了在治疗高血脂症方面的疗效外，还可能引起药物不良反应，主要包括肌肉疾病和肝功能异常。本研究旨在评估使用他汀类药物治疗慢性肾脏病患者新发肌少症的风险。 在一项全国性回顾性基于人群的队列研究中，从台湾全民健康保险研究数据库中选择了 1997 年至 2011 年间确诊的 75637 例慢性肾脏病患者。慢性肾脏病队列的选择包括慢性肾脏病的出院诊断或在 1 年内发现的慢性肾脏病诊断的 3 次以上门诊就诊。在考虑患者排除标准后，我们最终得到了研究中 67001 例慢性肾脏病患者。使用 Cox 比例风险模型对他汀类药物使用对新发肌少症发生的影响进行初步分析；使用具有时间依赖性协变量的 Cox 比例风险模型，考虑到个体用药时间上的差异，并在控制性别、年龄、收入和城市化水平后计算了风险比（HR）和 95%置信区间。 我们的主要发现表明，使用他汀类药物的慢性肾脏病患者似乎可以有效地预防肌少症的发生，大剂量的他汀类药物似乎显示出更显著的保护作用，并且在长期随访中结果相似。此外，脂溶性他汀类药物治疗的患者新发肌少症的风险低于亲水性他汀类药物治疗的患者。 似乎慢性肾脏病患者可以接受他汀类药物治疗以降低新发肌少症的发生。此外，较高剂量的他汀类药物可降低慢性肾脏病患者新发肌少症的发生率。
