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常用药物对吸烟者胸大肌纵向面积的影响。

Effect of Common Medications on Longitudinal Pectoralis Muscle Area in Smokers.

作者信息

Shirahata Toru, Enzer Nicholas A, Castro Victor, Chiles Joe, McDonald Merry-Lynn, Choi Bina, Diaz Alejandro A, Washko George R, San José Estépar Raúl, Ash Samuel Y, Rahaghi Farbod N

机构信息

Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States.

Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan.

出版信息

Chronic Obstr Pulm Dis. 2025 Jan 29;12(1):23-32. doi: 10.15326/jcopdf.2024.0557.

Abstract

BACKGROUND

Cigarette smoke contributes to skeletal muscle wasting. While exercise and nutritional therapies are effective in improving skeletal muscle quantity and quality, the effect of medications on longitudinal muscle loss is unclear. We investigated whether long-term use of common medications affects longitudinal skeletal muscle changes in current and former smokers.

METHODS

Using quantitative computed tomography imaging, we measured the 5-year changes in pectoralis muscle area (delta-PMA) and pectoralis muscle density (delta-PMD) of 4191 participants in the COPD Genetic Epidemiology (COPDGene) study. We tested whether specific medications were associated with delta-PMA and/or delta-PMD using regression analyses. Propensity score matching (PSM) analysis was performed to determine the effect of the medications on longitudinal changes on delta-PMA.

RESULTS

Over the study period, the median delta-PMA for the entire population showed a decrease of 2.23cm (interquartile range: -6.52, 1.54). Regression analyses demonstrated statin use was associated with less loss of PMA, whereas, aspirin use was associated with a greater loss of PMA. Specifically, in the PSM-adjusted analysis, statin use was associated with attenuated loss of PMA (median; -1.5 versus -2.5cm, =0.017), while aspirin use was associated with increased loss of PMA (median; -2.5 versus -1.9cm, =0.040).

CONCLUSION

In current and former smokers, statin use was associated with reduced pectoralis muscle wasting, while aspirin use was associated with increased muscle loss. Additional research is needed to verify these findings. (Clinicaltrials.gov identifier NCT00608764).

摘要

背景

香烟烟雾会导致骨骼肌萎缩。虽然运动和营养疗法在改善骨骼肌数量和质量方面有效,但药物对肌肉长期流失的影响尚不清楚。我们调查了长期使用常见药物是否会影响当前吸烟者和既往吸烟者的骨骼肌纵向变化。

方法

我们使用定量计算机断层扫描成像技术,测量了慢性阻塞性肺疾病遗传流行病学(COPDGene)研究中4191名参与者的胸肌面积(Δ-PMA)和胸肌密度(Δ-PMD)的5年变化情况。我们通过回归分析测试了特定药物是否与Δ-PMA和/或Δ-PMD相关。进行倾向评分匹配(PSM)分析以确定药物对Δ-PMA纵向变化的影响。

结果

在研究期间,整个人群的Δ-PMA中位数下降了2.23cm(四分位间距:-6.52,1.54)。回归分析表明,使用他汀类药物与胸肌面积减少较少相关,而使用阿司匹林则与胸肌面积减少较多相关。具体而言,在PSM调整分析中,使用他汀类药物与胸肌面积减少减弱相关(中位数;-1.5对-2.5cm,P=0.017),而使用阿司匹林与胸肌面积减少增加相关(中位数;-2.5对-1.9cm,P=0.040)。

结论

在当前吸烟者和既往吸烟者中,使用他汀类药物与胸肌萎缩减少相关,而使用阿司匹林与肌肉流失增加相关。需要进一步的研究来验证这些发现。(Clinicaltrials.gov标识符NCT00608764)

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