Pedroso Aline Fernandes, Barreto Sandhi Maria, Telles Rosa Weiss, Machado Luciana A C, Haueisen Sander Diniz Maria de Fátima, Duncan Bruce Bartholow, Figueiredo Roberta Carvalho
Graduate Program of Health Sciences, Federal University of Sao Joao del-Rei, Bloco D, Sala 306, R. Sebastião Gonçalves Coelho, 400, Chanadour, Divinópolis, MG, 35501-296, Brazil.
Medical School and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Cardiovasc Drugs Ther. 2024 Dec;38(6):1409-1414. doi: 10.1007/s10557-023-07476-7. Epub 2023 Jun 1.
PURPOSE: To investigate the association between statins and muscle problems in a highly diverse sample of Brazilian civil servants. METHODS: We conducted a cross-sectional data analysis at baseline of the ELSA-Brasil MSK cohort. Pain was identified through self-reported symptoms in large muscle groups (lower back and/or hips/thighs). Muscle strength was assessed using the five-times-sit-to-stand (FTSTS) and handgrip tests, with weakness defined as the lowest and highest quintiles of age- and sex-stratified handgrip strength and FTSTS performance time, respectively. Multivariable logistic regression analyses were conducted to investigate the association between statin use and muscle pain and weakness. Secondary analyses explored the impact of different types of statins and their duration of use on the response variables. RESULTS: A total of 2156 participants (mean age 55.6 ± SD 8.9, 52.8% women) were included, of whom 21.1% were taking statins and 25.1% reported muscle pain. We found no significant association between statin use and muscle problems. Secondary analysis on different types of statins revealed an association between atorvastatin and muscle weakness, as measured by the five-times-sit-to-stand test (OR 1.94, 95% CI 1.12-3.37), but not by the handgrip test (OR 0.75, 95% CI 0.29-1.42). No evidence was found to support a link between the duration of statin treatment and muscle problems. CONCLUSIONS: This study challenges previous claims of an efficacy-effectiveness gap between experimental and observational literature on statins. The findings indicate that statin use does not contribute to muscular problems.
目的:在巴西公务员这一高度多样化的样本中,研究他汀类药物与肌肉问题之间的关联。 方法:我们对ELSA - Brasil MSK队列的基线数据进行了横断面分析。通过大肌肉群(下背部和/或臀部/大腿)的自我报告症状来确定疼痛。使用五次坐立试验(FTSTS)和握力测试评估肌肉力量,将虚弱分别定义为年龄和性别分层的握力强度以及FTSTS表现时间的最低和最高五分位数。进行多变量逻辑回归分析,以研究他汀类药物使用与肌肉疼痛和虚弱之间的关联。二次分析探讨了不同类型他汀类药物及其使用时长对反应变量的影响。 结果:共纳入2156名参与者(平均年龄55.6 ±标准差8.9,52.8%为女性),其中21.1%正在服用他汀类药物,25.1%报告有肌肉疼痛。我们发现他汀类药物使用与肌肉问题之间无显著关联。对不同类型他汀类药物的二次分析显示,阿托伐他汀与肌肉虚弱之间存在关联,通过五次坐立试验测量(比值比1.94,95%置信区间1.12 - 3.37),但通过握力测试未发现关联(比值比0.75,95%置信区间0.29 - 1.42)。未发现证据支持他汀类药物治疗时长与肌肉问题之间存在联系。 结论:本研究对先前关于他汀类药物实验性文献与观察性文献之间存在疗效 - 效果差距的说法提出了挑战。研究结果表明,使用他汀类药物不会导致肌肉问题。
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