Tariq Sara, Goriparthi Lakshmi, Ismail Dina, Kankeu Tonpouwo Gauvain, Thapa Milan, Khalid Khizer, Cooper Ayden Charlene, Jean-Charles Gutteridge
Internal Medicine, Mayo Hospital, Lahore, PAK.
Internal Medicine, JC (Jean-Charles) Medical Center, Orlando, USA.
Cureus. 2023 Apr 17;15(4):e37708. doi: 10.7759/cureus.37708. eCollection 2023 Apr.
Diabetes is one of the most common chronic ailments; its incidence has reached epidemic proportions in the 21st century. Diabetes significantly increases micro and macrovascular complications, which are effectively managed with statins. Therefore, statins' pharmacokinetics, pharmacodynamics, and pharmacogenetics have been extensively studied. Although statins act as a keystone in preventing cardiovascular complications, at the same time, they pose a threat to the quality of life of diabetics due to the resulting muscular side effects. This article summarizes the prevalence, clinical manifestations, pathophysiology, and risk factors of statin-induced myopathy in diabetic patients. Among the diverse predisposing risk factors, the primary variables identified for causing myopathy in diabetic patients include age, gender, ethnicity, duration and severity of illness, comorbid conditions, level of physical activity, alcohol use, cholecalciferol (vitamin D3) levels, type and dose of statins, and anti-diabetic drugs or other drugs used concomitantly. In addition, cardiovascular risk quotients also potentially impact diabetic patients making them more vulnerable to developing myopathy from statins. Therefore, this study highlights the importance of managing statin-associated myopathic side effects by providing consensus guidelines on diagnostic, monitoring, and treatment strategies. We also discussed statins' prognostic value in reducing cardiovascular events in diabetic individuals.
糖尿病是最常见的慢性疾病之一；其发病率在21世纪已达到流行程度。糖尿病显著增加微血管和大血管并发症，他汀类药物可有效控制这些并发症。因此，对他汀类药物的药代动力学、药效学和药物遗传学进行了广泛研究。尽管他汀类药物是预防心血管并发症的关键药物，但同时，由于其导致的肌肉副作用，它们对糖尿病患者的生活质量构成威胁。本文总结了糖尿病患者他汀类药物所致肌病的患病率、临床表现、病理生理学和危险因素。在各种诱发危险因素中，已确定的导致糖尿病患者肌病的主要变量包括年龄、性别、种族、病程和病情严重程度、合并症、体力活动水平、饮酒情况、胆钙化醇（维生素D3）水平、他汀类药物的类型和剂量，以及同时使用的抗糖尿病药物或其他药物。此外，心血管风险商数也可能影响糖尿病患者，使他们更容易因他汀类药物而发生肌病。因此，本研究通过提供关于诊断、监测和治疗策略的共识指南，强调了管理他汀类药物相关肌病副作用的重要性。我们还讨论了他汀类药物在降低糖尿病个体心血管事件方面的预后价值。
