Vinci Pierandrea, Di Girolamo Filippo Giorgio, Pellicori Federica, Panizon Emiliano, Pirulli Alessia, Tosoni Letizia Maria, Altamura Nicola, Rizzo Stefania, Perin Andrea, Fiotti Nicola, Biolo Gianni
Unità Clinica Operativa Clinica Medica, Department of Medical, Surgical and Health Sciences, Faculty of Medicine, University of Trieste and ASUGI, 34149 Trieste, Italy.
Hospital Pharmacy, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, 34149 Trieste, Italy.
J Clin Med. 2025 Feb 13;14(4):1221. doi: 10.3390/jcm14041221.
Statin-associated muscle symptoms (SAMS) is a frequent side effect of statin therapy, limiting its clinical use and increasing cardiovascular risk. Its relationship with muscle performance and quality is not completely understood. The aim of our study was to retrospectively assess the differences between body composition and muscle strength in patients with SAMS, compared with matched controls. cardiovascular risk factors, lipid profile, and body mass index (BMI), were analyzed in 148 statin-intolerant (SI) and in 145 sex- and age-matched statin-tolerant (ST) patients attending a secondary-level outpatient lipid clinic. At the end of follow-up (mean 45 months), the evaluations were reassessed and bioelectrical impedance analysis (BIA)-assessed body composition, and muscle quality (handgrip/skeletal muscle mass) were further determined. At baseline, BMI, cholesterol, and triglycerides in SI were higher than in ST patients. During follow-up, SI patients underwent a further increase in BMI and low-density lipoproteins (LDL)-cholesterol remained significantly higher than in ST patients. At the end of the follow-up, BIA-assessed fat mass percentage was higher in SI than in ST. Handgrip absolute values or standardized for skeletal muscle mass (muscle quality) were significantly lower in SI patients ( < 0.001), but this was confirmed only in their non-dominant arm ( < 0.01 for all arms). Circulating creatine kinase levels, which was higher in SI patients at baseline ( < 0.001), remained higher in those who never restarted statins after re-challenge ( = 0.029). Statin intolerance is clinically associated with lower muscle quality, particularly in less exercised arms.
他汀类药物相关肌肉症状（SAMS）是他汀类药物治疗常见的副作用，限制了其临床应用并增加心血管风险。其与肌肉功能和质量的关系尚未完全明确。我们研究的目的是回顾性评估SAMS患者与匹配对照组在身体成分和肌肉力量方面的差异。对148例他汀类药物不耐受（SI）患者和145例年龄和性别匹配的他汀类药物耐受（ST）患者进行了分析，这些患者均在二级门诊血脂诊所就诊，分析了他们的心血管危险因素、血脂谱和体重指数（BMI）。在随访结束时（平均45个月），重新进行评估，并进一步测定生物电阻抗分析（BIA）评估的身体成分和肌肉质量（握力/骨骼肌质量）。基线时，SI患者的BMI、胆固醇和甘油三酯高于ST患者。随访期间，SI患者的BMI进一步升高，低密度脂蛋白（LDL）胆固醇仍显著高于ST患者。随访结束时，BIA评估的SI患者脂肪质量百分比高于ST患者。SI患者的握力绝对值或根据骨骼肌质量标准化后的握力（肌肉质量）显著较低（<0.001），但仅在其非优势手臂得到证实（所有手臂<0.01）。循环肌酸激酶水平在基线时SI患者较高（<0.001），在再次激发后未重新开始使用他汀类药物的患者中仍较高（=0.029）。他汀类药物不耐受在临床上与较低的肌肉质量相关，尤其是在较少运动的手臂。
