Statins — It has been thought that 3-hydroxy-3-methylglutaryl coenzyme-A (HMG-CoA) reductase inhibitors (statins), which are used for the treatment of hypercholesterolemia, may have beneficial effects on the skeleton, but data are conflicting. In some studies, statin therapy was associated with a decrease in fractures or an increase in bone density [91-95], but in others, there was no decrease in fractures [96-98]. Many of the studies included men (sometimes in a majority), the particular statin varied, and the design of the studies varied. Most were case-control or retrospective studies.
The Women"s Health Initiative (WHI) observational study, the largest observational study to address this issue, reported no reduction in fracture rates in postmenopausal statin users compared with nonusers after four years of follow-up [99]. (See "Overview of the management of osteoporosis in postmenopausal women".)
In a meta-analysis of eight observational studies that reported statin use and documented fracture outcomes in postmenopausal women (including the WHI observational study noted above), statin use was associated with a lower risk of hip fracture (odds ratio [OR] 0.43, 95% CI 0.25-0.75 for users versus nonusers) [100]. However, post hoc analyses of two cardiovascular trials did not support a protective effect [96,98].
In the one clinical trial to date, 82 postmenopausal women were randomly assigned to simvastatin (40 mg/day) or placebo for one year. There were no effects of simvastatin on biochemical bone markers or on BMD at the hip or spine, although an increase in bone density was seen in the forearm. Thus, observational data on statin use and beneficial effects on bone health have been conflicting, but in the one randomized clinical trial to address this, simvastatin did not appear to have an overall beneficial effect on bone [101].
從目前得到研究結果看，他汀類對糖尿病人骨質疏鬆的治療作用和減少骨折風險的作用存在爭議，但未得到他汀會減低服藥者骨密度的報告。
因此，從目前看沒有證據支援他汀會加重骨質疏鬆症！
他汀類藥物 - 人們一直認為用於治療高膽固醇血癥的3-羥基-3-甲基戊二醯輔酶A（HMG-CoA）還原酶抑制劑（他汀類藥物）可能對骨骼有益，但資料相互矛盾。在一些研究中，他汀類藥物治療與骨折減少或骨密度增加有關[ 91-95 ]，但在其他研究中，骨折沒有減少[ 96-98 ]。許多研究包括男性（有時佔大多數），特定他汀類藥物不同，研究設計也各不相同。大多數是病例對照或回顧性研究。
婦女健康倡議（WHI）觀察性研究，是解決這一問題的最大觀察性研究，報告絕經後他汀類藥物使用者的骨折率與未使用者相比，經過四年的隨訪後沒有減少[ 99 ]。（參見“絕經後婦女骨質疏鬆症管理概述”。）
在一項薈萃分析中，有八項觀察性研究報告了他汀類藥物的使用並記錄了絕經後婦女的骨折結果（包括上文提到的WHI觀察性研究），他汀類藥物的使用與髖部骨折的風險較低有關（優勢比[OR] 0.43,95使用者與非使用者的％CI 0.25-0.75）[ 100 ]。然而，兩項心血管試驗的事後分析不支援保護作用[ 96,98 ]。
在迄今為止的一項臨床試驗中，82名絕經後婦女被隨機分配到辛伐他汀（40 mg /天）或安慰劑一年。儘管前臂中骨密度增加，但辛伐他汀對生化骨標記物或髖部或脊柱BMD沒有影響。因此，他汀類藥物使用的觀察資料和對骨骼健康的有益影響一直存在矛盾，但在一項解決這一問題的隨機臨床試驗中，辛伐他汀似乎對骨骼沒有整體有益作用[ 101 ]。
英文原文：
Statins — It has been thought that 3-hydroxy-3-methylglutaryl coenzyme-A (HMG-CoA) reductase inhibitors (statins), which are used for the treatment of hypercholesterolemia, may have beneficial effects on the skeleton, but data are conflicting. In some studies, statin therapy was associated with a decrease in fractures or an increase in bone density [91-95], but in others, there was no decrease in fractures [96-98]. Many of the studies included men (sometimes in a majority), the particular statin varied, and the design of the studies varied. Most were case-control or retrospective studies.
The Women"s Health Initiative (WHI) observational study, the largest observational study to address this issue, reported no reduction in fracture rates in postmenopausal statin users compared with nonusers after four years of follow-up [99]. (See "Overview of the management of osteoporosis in postmenopausal women".)
In a meta-analysis of eight observational studies that reported statin use and documented fracture outcomes in postmenopausal women (including the WHI observational study noted above), statin use was associated with a lower risk of hip fracture (odds ratio [OR] 0.43, 95% CI 0.25-0.75 for users versus nonusers) [100]. However, post hoc analyses of two cardiovascular trials did not support a protective effect [96,98].
In the one clinical trial to date, 82 postmenopausal women were randomly assigned to simvastatin (40 mg/day) or placebo for one year. There were no effects of simvastatin on biochemical bone markers or on BMD at the hip or spine, although an increase in bone density was seen in the forearm. Thus, observational data on statin use and beneficial effects on bone health have been conflicting, but in the one randomized clinical trial to address this, simvastatin did not appear to have an overall beneficial effect on bone [101].