Neurology：维生素D缺乏卒中患者或更易他汀不耐受

第65届美国神经病学学会（AAN2013）年会公布的一项回顾性研究表明，与维生素D正常的卒中患者相比，维生素D缺乏者的多种他汀类不耐受发生率倾向于升高，但未达到统计学意义，尚需更大型的研究进一步评估这种相关性。
　　该研究共纳入197例应用他汀类并且测定血清25羟维生素D水平的卒中患者。将维生素D水平<30 ng/mL的患者分类为维生素D缺乏组。就他汀类不耐受情况对维生素D正常和缺乏组患者加以分析。利用Fisher精确检验对比两组患者的基线特征和他汀类治疗耐受情况。
　　结果显示，共有119例（60.4%）患者伴有维生素D缺乏。维生素D缺乏患者较为年轻，更有可能为女性和非洲裔美国人。在维生素D缺乏组患者中，11.8%（14例）对任何他汀类均不耐受，8.4%（10例）伴有肌肉相关性症状。维生素D缺乏组患者的多种他汀类不耐受发生率高于维生素D正常组（5.0%对0%；P=0.08）。
与卒中相关的拓展阅读：

• Neurology：卒中前应用他汀可改善老年患者短期转归
• STROKE:较大量膳食纤维摄入或降低首次卒中危险
• Neurology：和肽素有助判断缺血性卒中的预后
• Stroke：血管内卒中治疗合用替罗非班增加脑出血风险
• Stroke：卒中后抑郁症长期复发风险高 更多信息请点击：有关卒中更多资讯

Vitamin D Deficiency and Its Relationship to Statin Intolerance among Stroke Patients (PD7.002)
OBJECTIVE
The objective of our study was to examine the possible role of vitamin D deficiency and statin intolerance among stroke patients.
BACKGROUND
Statin therapy has been shown to be effective in secondary stroke prevention however muscle-related side effects can limit adherence to therapy. The vitamin D receptor is present in skeletal muscle and vitamin D deficiency can cause myopathy. There is limited data on the relationship of vitamin D deficiency to muscle-related side effects from statins.
DESIGN/METHODS
We conducted retrospective chart review of stroke patients seen in The Emory Clinic from October 1, 2010 to December 31, 2011. All patients with documentation of statin use and serum 25-hydroxy vitamin D level were included in this analysis. Patient were categorized as vitamin D deficient if their levels were <30 ng/mL. Normal and vitamin D deficient groups were analyzed for their tolerance to statin. Baseline characteristics and tolerance to statin therapy were analyzed between normal and vitamin D deficiency group using Fishers Exact test.
RESULTS
Of 197 patients included in the study, 119 patients (60.4%) had vitamin D deficiency. Patients with deficiency were younger, more likely to be female and African American. Within the vitamin D deficient group, 14 (11.8%) did not tolerate any statin and 10 (8.4%) had muscle-related complant. Intolerance to multiple statins was more frequent in patients with vitamin D deficiency versus those with normal vitamin D (5.0% vs 0%; p=0.08).
CONCLUSIONS
We found that vitamin D deficient stroke patients tended to have higher rates of intolerance to multiple statins compared with patients who had normal levels but this did not reach significance. A larger study is needed to better evaluate the relationship between statin intolerance and vitamin D deficiency.