Antonenko Alisa, Leahy Aoife, Babenko Mihaly, Lyons Declan
University Hospital Limerick, St. Nessan's Road, Dooradoyle, co. Limerick V94F858, Ireland.
Bone Rep. 2021 Nov 30;16:101152. doi: 10.1016/j.bonr.2021.101152. eCollection 2022 Jun.
The correlation between atherosclerosis and osteoporosis, independent of age, is clear. Multifactorial co-dependence between bone mineral density (BMD) and statin dose has been proposed. It is hypothesised that inhibition of the synthesis of cholesterol will also inhibit the synthesis of sex hormones and Vitamin D, negatively affecting BMD. This study aims to evaluate hydrophilic and non-hydrophilic statins effect on osteoporosis and analyse any possible superiority of one agent over the other within the group.
We identified 538 caucasian females who had a DEXA scan performed between 2002 and 2016 (age 60-89) in one DEXA center in Mid-West Ireland. A DEXA T-score results were analysed in the current study. Two hundred fifty females were not on statin therapy, and 323 females were on statin therapy. Females on therapy were separated into the atorvastatin group ( = 190), rosuvastatin group ( = 97), and pravastatin group ( = 36), comprising low dose and high dose groups. All anonymised data were analysed with SPSS statistical. To test the hypothesis that lower bone density is associated with high dose statins, an independent sample -test was performed. The one-way between-groups ANOVA test was used to test the hypothesis that the BMD level depended on the statin's potency.
Statin-naïve females have a statistically higher bone mineral density in the lumbar spine, t (538) = 3.42, < 0.05 and in hip t (538) = 4.99, p < 0.05 than females on statin therapy. There was a significant difference in patient's age between the group, and no significant correlation was found between the patient's age and type of statin or bone density. In the atorvastatin group statistically, significant results were obtained both for spine and hip bone mineral density, t (188) = -5.61, < 0.05 and t (188) = -3.62, p < 0.05, respectively. In the rosuvastatin group, statistically, a significant result was noted for bone mineral density of hip t (95) = -3.52, < 0.05. This demonstrates a dose-dependency between bone mineral density and the dose of the statin. The independent between-group ANOVA yielded a statistically significant effect, F (2, 59) = 6.69, p < 0.05, η2 = 0.21 in the spine. Thus, patients on lipophilic statins had statistically lower BMD than females on hydrophilic statins. Multilinear regression analysis identified that age is not a statistically significant contributor in our analysis; however, the trend of decrease in bone mineral density with women's age is acknowledged by authors.
The study results support the theory that bone mineral density decreases with an increase in a statin dose, and hydrophilic statins, like pravastatin, have a better metabolic profile in the lumbar spine than lipophilic agents.
动脉粥样硬化与骨质疏松之间的相关性明确，且不受年龄影响。有人提出骨密度（BMD）与他汀类药物剂量之间存在多因素共同依赖性。据推测，胆固醇合成的抑制也会抑制性激素和维生素D的合成，对骨密度产生负面影响。本研究旨在评估亲水性和非亲水性他汀类药物对骨质疏松的影响，并分析组内一种药物相对于另一种药物的任何可能优势。
我们确定了538名在2002年至2016年期间于爱尔兰中西部的一个双能X线吸收仪（DEXA）中心进行DEXA扫描的白种女性（年龄60 - 89岁）。本研究分析了DEXA T评分结果。250名女性未接受他汀类药物治疗，323名女性接受他汀类药物治疗。接受治疗的女性被分为阿托伐他汀组（n = 190）、瑞舒伐他汀组（n = 97）和普伐他汀组（n = 36），每组又分为低剂量组和高剂量组。所有匿名数据均采用SPSS统计学软件进行分析。为检验较低骨密度与高剂量他汀类药物相关的假设，进行了独立样本t检验。组间单因素方差分析用于检验骨密度水平取决于他汀类药物效力的假设。
未服用他汀类药物的女性在腰椎的骨密度显著高于服用他汀类药物的女性，t（538） = 3.42，p < 0.05；在髋部，t（538） = 4.99，p < 0.05。两组患者年龄存在显著差异，且未发现患者年龄与他汀类药物类型或骨密度之间存在显著相关性。在阿托伐他汀组，腰椎和髋部骨密度均获得了统计学显著结果，分别为t（188） = -5.61，p < 0.05和t（188） = -3.62，p < 0.05。在瑞舒伐他汀组，髋部骨密度有统计学显著结果，t（9五） = -3.52，p < 0.05。这表明骨密度与他汀类药物剂量之间存在剂量依赖性。组间独立方差分析在腰椎产生了统计学显著效应，F（2, 59） = 6.69，p < 0.05，η2 = 0.21。因此，服用亲脂性他汀类药物的患者骨密度在统计学上低于服用亲水性他汀类药物的女性。多元线性回归分析表明，年龄在我们的分析中不是统计学显著因素；然而，作者承认骨密度随女性年龄下降的趋势。
研究结果支持骨密度随他汀类药物剂量增加而降低的理论，并且亲水性他汀类药物，如普伐他汀，在腰椎的代谢情况优于亲脂性药物。
