他汀类药物对高胆固醇绝经后妇女骨密度的影响

Effects of statins upon bone mineral density in postmenopausal women with hypercholesterolemia

目的观察他汀类药物对高胆固醇血症绝经后妇女骨密度（BMD）及骨代谢标志物的影响及其对骨质疏松症（OP）的治疗机制。方法将2011年1月至2012年8月就诊的100例符合入组标准的骨量减少或骨质疏松合并高胆固醇血症的绝经后妇女随机分为两组，即对照组和治疗组（服用阿托伐他汀钙10mgqd）。观察两组患者半年、1年后腰椎BMD、骨吸收标志物Ⅰ型胶原交联C-端肽（CTX）、骨合成标志物I型前胶原N-端肽（PINP）的变化情况，并进行组内及组间比较。结果治疗组的腰椎BMD及PINP在半年及1年后均有上升的趋势。治疗组腰椎BMD与对照组相比差异有统计学意义，（0．68±0．14）比（0．74±0．12），（P〈0．05）。治疗组PINP值在1年后明显改善，（38．8±8．9）比（40．2±8．6），（P〈0．05），该差值高于对照组的差值，两者差异也有统计学意义，（38．4±8．6）比（42．1±8．3），（P〈0．05）。结论他汀类药物对维持或增加高胆固醇血症绝经后妇女骨量有一定帮助，它是通过促进骨合成代谢来实现其抗骨质疏松的作用。

Objective To explore the effects of statins upon bone mineral density （BMD） and bone metabolic markers in postmenopausal women with hypercholesterolemia. Methods A prospective study was conducted for 100 women receiving treatment from January 2011 to August 2012 and meeting the inclusion criteria of osteopenia or osteoporosis with hypercholesterolemia postmenopausal. They were randomly divided into treatment group on atorvastatin 10 mg once daily and control group. The parameters of lumbar BMD, bone resorption markers of type I collagen cross-linked C-telopeptide （CTX） , bone synthesis markers procollagen type ｜ N-terminal peptide （PINP） were compared between two groups after half a year and one year. Results There was an upward trend of lumbar spine BMD and PINP in the treatment group at half a year and one year compared with the control group. And two groups had significant difference （ P 〈 0. 05 ）. Although two groups had no significant difference in all parameters at half a year, the values of lumbar spine BMD and PINP were higher in the treatment group at one year than the control group. Two groups had significant difference （P 〈 0. 05 ）. Conclusions Statins can help maintain or increase bone mass of hypercholesterolemic menopausal women through promoting bone synthesis.