HMG-CoA還元酵素阻害剤と骨折のリスク
C R Meier1, R G Schlienger, M E Kraenzlin
1Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology, University Hospital of Basel, Petersgraben 4, CH-4031, Basel, Switzerland. Christoph.Meier@unibas.ch
JAMA
|June 24, 2000
まとめ
コレステロールを下げる薬の1種類であるスタチンは,50歳以上の個人に骨折のリスクを大幅に低減します. これは,骨折の予防に有意な効果を示さなかった繊維酸および他の脂質低下薬とは対照的です.
科学分野:
- 薬理学 薬理学とは
- 骨代謝についてです.
- エピデミオロジー エピデミオロジー
背景:
- 動物の研究は,HMG-CoA還元酵素阻害剤 (スタチン) が骨の形成,体積,密度を高めることを示唆しています.
- スタチンの使用と骨折のリスクとの関連性に関するヒトのデータは限られている.
研究 の 目的:
- スタチン,フィブラート,または他の脂質低下薬が骨折のリスクの低下と関連しているかどうかを調査する.
- 脂質低下薬が骨格の健康に与える影響を評価する.
主な方法:
- イギリスの一般医療研究データベース (GPRD) を利用した,集団ベースの,内蔵された症例対照研究.
- 分析には50歳以上の91,000人以上の個人が含まれており,骨折症例 (n=3940) と対照群 (n=23,379) を比較した.
- BMI,喫煙,医師の診察,コルチコステロイド,エストロゲンの使用に調整されています.
主要な成果:
- 現在のスタチンの使用は,骨折リスクの低下と有意に関連していました (調整されたOR,0.55;95%CI,0.44-0.69).
- 繊維酸および他の脂質低下薬は,骨折リスクの低下と有意な関連性を示さなかった.
- 繊維酸およびその他の脂質低下薬の調整された確率比は,それぞれ0.87 (95%CI,0.70-1.08) と0.76 (95%CI,0.41-1.39) でした.
結論:
- 現在のスタチンの暴露は,50歳以上の個人に骨折のリスクが低いとの関連があるようです.
- これらの発見は,骨の健康に対するスタチンの潜在的な公衆衛生上の利点を示唆しています.
- 将来の試験によるさらなる確認が推奨されます.
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