Ho JaHyun, Kim Bokyoung, Kim Kue Sook, Jihn Chang-Ho, Kim Min-Young, Kang Dae Ryong, Park You Hyun, Ahn Jihyun
Division of Hospital Medicine, Korea Cancer Center Hospital, Seoul, Korea.
Department of Nursing, Catholic Kwandong University, Gangneung, Korea.
Ann Geriatr Med Res. 2021 Dec;25(4):269-277. doi: 10.4235/agmr.21.0103. Epub 2021 Dec 16.
We investigated the comorbidities of individuals who were prescribed statins to identify the use of bone mineral density (BMD)-reducing drugs, examine polydrug use trends involving these drugs, and explore their relationship with osteoporosis.
We analyzed claims data from the Korean National Health Insurance Service (January 2014-December 2018). We sampled 20% of 8,379,419 patients aged ≥50 years who were prescribed statins. Among them, we analyzed the data of those who were administered two or more prescriptions for 14 days or longer within 6 months of the initial date of statin prescription. Data on comorbidities and drugs that can potentially reduce BMD were obtained. Osteoporosis-related diagnoses were obtained as an outcome measure. The relationship between statins and BMD-reducing drugs was analyzed using logistic regression.
Among the 4,138 statin users aged 50 years or older, 552 were diagnosed with osteoporosis. The most common comorbidity in statin users was hypertension, followed by ischemic heart disease, diabetes mellitus, and stroke. The most frequently administered BMD-reducing drugs were proton pump inhibitors (PPIs). The osteoporosis diagnosis rate was higher in patients who were prescribed both statins and PPIs or both statins and levothyroxine than in those using only a statin.
PPIs and levothyroxine should be prescribed cautiously in statin users and bone densitometry should be proactively performed considering the increased risk of osteoporosis.
我们调查了服用他汀类药物的个体的合并症，以确定骨密度（BMD）降低药物的使用情况，研究涉及这些药物的多药使用趋势，并探讨它们与骨质疏松症的关系。
我们分析了韩国国民健康保险服务中心（2014年1月至2018年12月）的理赔数据。我们从8379419名年龄≥50岁且服用他汀类药物的患者中抽取了20%作为样本。其中，我们分析了在他汀类药物处方初始日期后的6个月内接受两种或更多种处方且持续14天或更长时间的患者的数据。获取了合并症和可能降低骨密度的药物的数据。以骨质疏松症相关诊断作为结局指标。使用逻辑回归分析他汀类药物与降低骨密度药物之间的关系。
在4138名年龄在50岁及以上的他汀类药物使用者中，552人被诊断为骨质疏松症。他汀类药物使用者中最常见的合并症是高血压，其次是缺血性心脏病、糖尿病和中风。最常使用的降低骨密度的药物是质子泵抑制剂（PPI）。同时服用他汀类药物和PPI或同时服用他汀类药物和左甲状腺素的患者的骨质疏松症诊断率高于仅使用他汀类药物的患者。
在他汀类药物使用者中应谨慎使用PPI和左甲状腺素，考虑到骨质疏松症风险增加，应积极进行骨密度测定。
