PDF(Pubmed)
Abstract：
BACKGROUND: Statins are the first-line treatment for dyslipidemia, which is a major modifiable risk factor for atherosclerotic cardiovascular disease. Studies have shown that in addition to the beneficial lipid-lowering effect, statins also exhibit a number of pleiotropic effects that may find application in other diseases, including osteoporosis. This study aimed to assess the effect of statins on bone turnover, as measured by the concentration of bone turnover markers, and to compare the effect of atorvastatin as a lipophilic statin and rosuvastatin as a hydrophilic statin.
METHODS: This study included 34 postmenopausal women aged < 65 years with newly diagnosed dyslipidemia requiring statin therapy. Patients were randomly assigned to receive a statin drug. Statins were initiated at standard doses of 5 to 10 mg of rosuvastatin and 20 mg of atorvastatin. The levels of C-terminal telopeptide of type I collagen as a bone resorption marker and N-terminal propeptide of procollagen type I as a marker of bone formation, lipid concentrations and other biochemical parameters were assessed at baseline and after 6 and twelve months of treatment.
RESULTS: There were no statistically significant differences between the levels of bone turnover markers before and 6 months after statin implementation (P > .05) - for all patients or subgroups according to statin use. Analysis of the results showed that after 12 months, there was a statistically significant decrease in N-terminal propeptide of procollagen type I concentration in all subjects (P = .004). By statin subgroup, a statistically significant decrease in N-terminal propeptide of procollagen type I was observed only in patients receiving rosuvastatin (P = .012) and not in those receiving atorvastatin (P = .25). Moreover, changes in bone turnover markers did not correlate with changes in lipid concentrations.
CONCLUSIONS: These results may indicate the superiority of atorvastatin over rosuvastatin in inhibiting adverse changes in bone turnover in postmenopausal women. Confirmed by studies involving a larger population, the observed differences might find particular applications in clinical practice, and the choice of atorvastatin over rosuvastatin for women could be considered in the early postmenopausal period to reduce the risk of osteoporosis and subsequent osteoporotic fractures.
METHODS: This study included 34 postmenopausal women aged < 65 years with newly diagnosed dyslipidemia requiring statin therapy. Patients were randomly assigned to receive a statin drug. Statins were initiated at standard doses of 5 to 10 mg of rosuvastatin and 20 mg of atorvastatin. The levels of C-terminal telopeptide of type I collagen as a bone resorption marker and N-terminal propeptide of procollagen type I as a marker of bone formation, lipid concentrations and other biochemical parameters were assessed at baseline and after 6 and twelve months of treatment.
RESULTS: There were no statistically significant differences between the levels of bone turnover markers before and 6 months after statin implementation (P > .05) - for all patients or subgroups according to statin use. Analysis of the results showed that after 12 months, there was a statistically significant decrease in N-terminal propeptide of procollagen type I concentration in all subjects (P = .004). By statin subgroup, a statistically significant decrease in N-terminal propeptide of procollagen type I was observed only in patients receiving rosuvastatin (P = .012) and not in those receiving atorvastatin (P = .25). Moreover, changes in bone turnover markers did not correlate with changes in lipid concentrations.
CONCLUSIONS: These results may indicate the superiority of atorvastatin over rosuvastatin in inhibiting adverse changes in bone turnover in postmenopausal women. Confirmed by studies involving a larger population, the observed differences might find particular applications in clinical practice, and the choice of atorvastatin over rosuvastatin for women could be considered in the early postmenopausal period to reduce the risk of osteoporosis and subsequent osteoporotic fractures.
摘要：
背景：他汀类药物是治疗血脂异常的一线药物，这是动脉粥样硬化性心血管疾病的主要可改变的危险因素。研究表明，除了有益的降脂作用外，他汀类药物还表现出许多多效性作用，可能在其他疾病中应用，包括骨质疏松症.本研究旨在评估他汀类药物对骨转换的影响，通过骨转换标志物的浓度来衡量，并比较阿托伐他汀作为亲脂性他汀和瑞舒伐他汀作为亲水性他汀的效果。
方法：本研究纳入34名绝经后女性，年龄<65岁，新诊断为血脂异常，需要他汀类药物治疗。患者被随机分配接受他汀类药物。他汀类药物以5至10mg瑞舒伐他汀和20mg阿托伐他汀的标准剂量开始。作为骨吸收标志物的I型胶原的C末端端肽和作为骨形成标志物的I型前胶原的N末端前肽的水平,在基线和治疗6个月和12个月后评估血脂浓度和其他生化指标.
结果：根据他汀类药物的使用情况，所有患者或亚组的骨转换标志物水平在应用他汀类药物前和应用后6个月之间没有统计学上的显著差异（P>.05）。分析结果显示,12个月后,在所有受试者中,I型前胶原的N端前肽浓度均有统计学显著降低(P=.004).通过他汀类药物亚组，仅在接受瑞舒伐他汀(P=.012)的患者中观察到I型前胶原的N端前肽显著下降,而在接受阿托伐他汀的患者中观察不到(P=.25).此外，骨转换标志物的变化与脂质浓度的变化无关.
结论：这些结果可能表明阿托伐他汀在抑制绝经后妇女骨转换不良变化方面优于瑞舒伐他汀。通过涉及更大人群的研究证实，观察到的差异可能会在临床实践中找到特定的应用，对于绝经后早期的女性,可考虑选择阿托伐他汀而不是瑞舒伐他汀,以降低骨质疏松和随后的骨质疏松性骨折的风险.
方法：本研究纳入34名绝经后女性，年龄<65岁，新诊断为血脂异常，需要他汀类药物治疗。患者被随机分配接受他汀类药物。他汀类药物以5至10mg瑞舒伐他汀和20mg阿托伐他汀的标准剂量开始。作为骨吸收标志物的I型胶原的C末端端肽和作为骨形成标志物的I型前胶原的N末端前肽的水平,在基线和治疗6个月和12个月后评估血脂浓度和其他生化指标.
结果：根据他汀类药物的使用情况，所有患者或亚组的骨转换标志物水平在应用他汀类药物前和应用后6个月之间没有统计学上的显著差异（P>.05）。分析结果显示,12个月后,在所有受试者中,I型前胶原的N端前肽浓度均有统计学显著降低(P=.004).通过他汀类药物亚组，仅在接受瑞舒伐他汀(P=.012)的患者中观察到I型前胶原的N端前肽显著下降,而在接受阿托伐他汀的患者中观察不到(P=.25).此外，骨转换标志物的变化与脂质浓度的变化无关.
结论：这些结果可能表明阿托伐他汀在抑制绝经后妇女骨转换不良变化方面优于瑞舒伐他汀。通过涉及更大人群的研究证实，观察到的差异可能会在临床实践中找到特定的应用，对于绝经后早期的女性,可考虑选择阿托伐他汀而不是瑞舒伐他汀,以降低骨质疏松和随后的骨质疏松性骨折的风险.
