辛伐他汀和吉非罗齐对高脂血症伴骨量减少患者骨代谢和骨密度的影响

Effects of Simvastatin and Gemfibrozil on bone metabolism and bone mineral density in patients with hypercholesterolemia and osteopenia

目的观察辛伐他汀和吉非罗齐对高胆固醇血症伴骨量减少患者骨代谢指标及骨密度的影响。方法高脂血症合并骨量减少患者128例,分两组后分别予以辛伐他汀和吉非罗齐治疗,并在治疗前及治疗后分别检测血脂、骨吸收标志物血清I型胶原羧基末端肽(sCTX)、骨形成标志物总骨Ⅰ型前胶原N端肽(P1NP)和桡骨远端骨密度(BMD)。结果辛伐他汀组平均治疗周期(10.24±1.89)个月,治疗后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)明显降低(P<0.05),同时sCTX降低(P<0.01),P1NP增高(P<0.05),BMD增加(P<0.01),而吉非罗齐治疗后虽TC、TG、LDL-C明显降低(P<0.05)但sCTX、P1NP和BMD无明显变化。结论较大剂量辛伐他汀具有抑制骨吸收、增强骨形成和增加BMD的作用,可能与血脂水平降低无关。

Objective To compare the effects of Simvastatin and Gemfibrozil on bone metabolism and bone mineral density（BMD） in patients with hypercholesterolemia and osteopenia.Methods Totally 128 with hypercholesterolemia and osteopenia were divided into Simvastatin group and Gemfibrozil group.The blood lipid,bone absorption maker sCTX,bone formation makers P1NP and BMD at distal end of radius were measured before and after the treatment with Simvastatin and Gemfibrozil.Results The total cholesterol（TC）,total triglycerides（TG） and low density lipoprotein cholesterol（LDL-C） were obviously lowered in both group（P0.05）.The sCTX was lowered（P0.01）,P1NP was raised（P0.05）and BMD was increased（P0.01）in Simvastatin group but no change of sCTX,P1NP and BMD was observed in Gemfibrozil group.Conclusion Moderate to high dosage of simvastatin is beneficial to inhibiting bone absorption,enhancing bone formation and increasing BMD and it may in no relation with lowered level of blood lipid.