Orces Carlos H, Montalvan Martha, Tettamanti Daniel
Rheumatology, Laredo Medical Center, Laredo, USA.
Investigación Biomedicina, Universidad De Granada España, Granada, ESP.
Cureus. 2020 Jul 1;12(7):e8950. doi: 10.7759/cureus.8950.
Background Randomized and observational studies have previously reported inconsistent results for the direct association between statin therapy and 25, hydroxyvitamin D [25(OH)D] levels. Thus, the present study aimed to examine the relationship between statin use and 25(OH)D and its metabolites concentrations in a large nationally representative sample of older adults. Methods This study was conducted using data from the National Health and Nutrition Examination Survey. Participants were asked to show the medication containers of all the products used in the previous 30 days, and the prescription of statins was defined on the three-level nested therapeutic classification scheme of Cerner Multum's Lexicon. General linear models adjusted for potential confounders were created to compare 25(OH)D concentrations between older adults taking statins and those who did not. Results A total of 6,261 participants with a mean age of 69.5 years comprised the study sample. Of those, 40.2% were taking statins with a median length of therapy of 5 years. Adjusted mean 25(OH)D and 25(OH)D levels were 3.3 and 4.4 nmol/L higher among participants taking statins than those who did not, respectively. Moreover, this association was consistently seen regardless of the duration of therapy and particularly in subjects taking simvastatin, atorvastatin, or rosuvastatin. In subgroup analyses according to BMI categories and vitamin D intake, higher 25(OH)D levels were also seen among statin users. By contrast, this association was attenuated among those with a daily vitamin D between 400 and 800 and >800 IU. Conclusion Older adults on statin therapy had significantly higher serum 25(OH)D concentrations. Additional research should be conducted to define the mechanism of this association and determine if the pleiotropic effects attributed to statins may be mediated by vitamin D.
背景 随机研究和观察性研究先前报道了他汀类药物治疗与25-羟维生素D[25(OH)D]水平之间直接关联的结果不一致。因此，本研究旨在在一个具有全国代表性的老年人大样本中，研究他汀类药物使用与25(OH)D及其代谢物浓度之间的关系。方法 本研究使用了来自美国国家健康与营养检查调查的数据。参与者被要求展示过去30天内使用的所有产品的药瓶，他汀类药物的处方根据erner Multum词汇表的三级嵌套治疗分类方案定义。建立了针对潜在混杂因素进行调整的一般线性模型，以比较服用他汀类药物的老年人与未服用他汀类药物的老年人之间的25(OH)D浓度。结果 共有6261名平均年龄为69.5岁的参与者组成了研究样本。其中，40.2%的人正在服用他汀类药物，中位治疗时长为5年。服用他汀类药物的参与者的调整后平均25(OH)D和25(OH)D水平分别比未服用者高3.3和4.4nmol/L。此外，无论治疗持续时间如何，尤其是在服用辛伐他汀、阿托伐他汀或瑞舒伐他汀的受试者中，这种关联始终存在。在根据体重指数类别和维生素D摄入量进行的亚组分析中，他汀类药物使用者的25(OH)D水平也较高。相比之下，在每日维生素D摄入量在400至800国际单位和大于800国际单位的人群中，这种关联减弱。结论 接受他汀类药物治疗的老年人血清25(OH)D浓度显著更高。应开展进一步研究以明确这种关联的机制，并确定他汀类药物的多效性作用是否可能由维生素D介导。
