观察到他汀类药物can stimulate bone formation was first made at least 20 years ago. In 1999, for example, researchers reported inSciencethat two statins increased bone formation and bone volume in mice and rats. Later studies confirmed the effect in humans, including a systematicreview and meta-analysis published in January 2017 in骨质疏松症国际，，，，which found the use of statins is associated with increased bone mineral density in the hip area and lumbar spine.
Now a9月26日发表的研究Annals of the Rheumatic Diseasessuggests that while lower doses of statins may help prevent osteoporosis — a condition in which bones become less dense and, consequently, more likely to break — taking too much may actually impair bone health.
对大约800万奥地利成年人的健康记录的分析显示，每天服用多达10毫克的骨质疏松症病例较少lovastatin，，，，pravastatin，，，，simvastatin， 或者rosuvastatincompared with those not taking statins.
但科学家发现,t的趋势逆转hose taking statins in daily doses of 20 milligrams or more, and the higher the dosage, the stronger this effect.
“我们能够证明在高剂量汀类药物治疗下被诊断出骨质疏松症的高风险，而低剂量的他汀类药物与较低骨质疏松症的风险”，首席调查员说迈克尔·卢特纳（Michael Leutner），医学博士，在奥地利维也纳医科大学临床内分泌与代谢临床学系的博士生。
More specifically, people who were taking 0 to 10 milligrams of simvastatin daily had a 30 percent lower risk of being diagnosed with osteoporosis when compared with people not taking statins.
另一方面，与非STATIN使用者相比，每天服用40至60毫克的辛伐他汀的人被诊断出患有骨质疏松症的风险增加了64％，而每天服用60至80毫克的人的风险高230％。
Results were similar for the other statins.
胆固醇对性激素的影响可能起作用
他汀类药物如何对骨骼发挥作用并不完全知道。
“In mouse models and in vitro studies [lab studies using human cells], statins have been shown to enhance bone formation, for example by increasing the expression ofbone morphogenic protein (BMP2)，，，，which is an osteoprotective protein,” says one of the study's coauthors,亚历山德拉·考茨基·威勒（Alexandra Kautzky-Willer），医学博士，性别医学部门负责人和维也纳医科大学的性别医学课程。
研究人员推测，他汀类药物（通过降低人体的胆固醇产生）可能会影响性激素的水平，因此会影响骨质疏松症。Cholesterol is a basic building block为了生产雌激素激素和睾丸激素。
“In higher dosages, the possible inhibiting effect of statins on sex hormones could overrule the osteoprotective effect,” says Dr. Kautzky-Willer.
研究作者指出，骨质疏松症的风险，包括骨折的较高风险，尤其高。post-menopausal women。确实，根据疾病预防与控制中心，65岁以上的4分之一的美国女性患有骨质疏松症，而65岁以上的20名美国男性患有这种情况。
Leutner博士说：“由于雌激素的骨化作用，绝经后女性的性激素下降是骨质疏松症的重要危险因素。”
Lower levels of睾丸激素in men也有关联with lower bone mineral density.
Study authors point out that women taking 0 to 10 milligrams of simvastatin had a 26 percent lower risk of being diagnosed with osteoporosis when compared with nonusers. Those taking a higher amount, of 60 to 80 milligrams, had a 272 percent higher risk.
对于男性，服用0到10毫克的辛伐他汀的人在服用60至80毫克药物时的风险下降了42％，但与非使用者相比，被诊断出患有骨质疏松症的风险低42％。
如果您目前服用他汀类药物怎么办？
他汀类药物通过降低高位，在降低心脏病发作，中风和其他心血管事件的风险方面具有良好的记录cholesterol levels，，，，according to theAmerican Heart Association。
当血液水平“坏”胆固醇（低密度脂蛋白或LDL）increase, fatty deposits can build up in the arteries, which can reduce or block blood flow to the heart.
医学博士康妮·纽曼（Connie Newman），an adjunct professor of medicine in the division of endocrinology, diabetes, and metabolism at New York University School of Medicine in New York City, and the president of the American Medical Women's Association, cautions that this study should not discourage people from taking the potentially lifesaving medications.
“患者应继续他汀类药物治疗lower cholesterol和reduce their risk of cardiovascular disease,” says Dr. Newman, who was not involved in this research. “This applies to all patients, including those with osteoporosis and those at increased risk of osteoporosis.”
纽曼指出，这项研究是观察性的，而不是随机对照试验。也就是说，科学家的结果基于对2006年和2007年超过790万成年人的健康数据的统计分析，以衡量诊断骨质疏松症在他汀类药物用户中，与由非Statin用户组成的对照组相比。
“Observational studies are subject to numerous biases that could confound the results, and cannot make valid conclusions about cause and effect,” says Newman. “In short, the proper interpretation of these data is critical to avoid misleading doctors and the public. My advice to all patients is to reassure them that statins — at low or high doses — have not been shown to cause osteoporosis.”
需要更多的研究来阐明他汀类药物与骨质疏松症之间的关系
维也纳医科大学研究小组计划进一步的前瞻性研究，以探索他汀类药物与骨质疏松症之间的关系。
“We propose that monitoring high-risk patients, that is, post-menopausal female patients under high-dosage statin therapy, might be useful to offer an individual therapy to prevent ortreat osteoporosis，”研究作者写道。“因此，应进行更大的前瞻性研究，重点是汀类药物，以阐明与骨质疏松症的关系。”
