BackgroundInconsistent results have been reported concerning the association between statin administration and muscle health, specifically its potential to increase the risk of sarcopenia. Given the widespread long‐term use of statins among the elderly population, the exploration of this association remains a crucial yet insufficiently examined matter. This study aimed to assess the association between the prolonged administration of statins and the risk of sarcopenia, diminished muscle strength, reduced skeletal muscle mass and impaired physical performance.MethodsThis population‐based cohort study was conducted in Japan utilizing data derived from the National Institute for Longevity Sciences‐Longitudinal Study of Aging (NILS‐LSA). The study participants, enlisted from the 2nd to the 6th waves (spanning from April 2000 to July 2010) of NILS‐LSA, were those who aged 40 years or older and had initiated statin therapy (n = 348, age: 64.1 years, female: 63.5%). Individuals who were not administered statins (n = 2559, age: 55.5 years, female: 48.4%) were arbitrarily chosen using a combined approach of propensity score (PS) matching and risk set sampling to form the control group (with a 1:4 matching ratio). The primary outcome of this study was the occurrence of sarcopenia, as defined by the 2019 consensus of the Asian Working Group for Sarcopenia (AWGS). The secondary outcomes included low muscle mass (< 7.0 kg/m2 for men and below 5.4 kg/m2 for women by DXA), reduced skeletal muscle strength (handgrip strength < 28 kg in men and < 18 kg in women) and subpar physical performance (6‐min walking speed < 1.0 m/s). The relationship between the use of statins and the outcomes was estimated using a Cox proportional hazard model with time‐varying covariates, which included the status of statin use and other variables (two‐tailed p < 0.05 was considered statistically significant). Stratification based on age and sex, along with five sensitivity analyses—including propensity score overlap weighting and a negative control—was conducted.ResultsAfter applying PS matching, we identified 342 statin initiators and 1294 non‐statin users, with well‐balanced baseline characteristics between the groups. The use of statins was not associated with an increased risk of incident sarcopenia (adjusted hazard ratio [aHR], 1.43 [95% CI, 0.86, 2.36]), diminished muscle strength (aHR, 1.11 [95% CI, 0.80, 1.54]), reduced muscle mass (aHR, 1.09 [95% CI, 0.66, 1.82]) or impaired physical performance (aHR, 0.73 [95% CI, 0.46, 1.17]). These findings were consistent across age and sex stratifications, as well as all sensitivity analyses.ConclusionsStatin use was not associated with an elevated risk of sarcopenia or impaired muscle health among community‐dwelling middle‐aged and older adults in Japan.

中文翻译：

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日本社区中老年人长期使用他汀类药物后发生肌肉减少症的风险


背景关于他汀类药物给药与肌肉健康之间的关联，特别是其增加肌肉减少症风险的可能性，已报告了不一致的结果。鉴于他汀类药物在老年人群中的广泛长期使用，对这种关联的探索仍然是一个关键但未得到充分研究的问题。本研究旨在评估他汀类药物的长期给药与肌肉减少症、肌肉力量下降、骨骼肌质量减少和身体机能受损风险之间的关联。方法这项基于人群的队列研究是在日本进行的，利用来自国家长寿科学研究所-老龄化纵向研究 （NILS-LSA） 的数据。研究参与者从 NILS-LSA 的第 2 波到第 6 波（从 2000 年 4 月到 2010 年 7 月）招募，是年龄在 40 岁或以上并已开始他汀类药物治疗的人 （n = 348，年龄：64.1 岁，女性：63.5%）。未服用他汀类药物的个体 （n = 2559，年龄：55.5 岁，女性：48.4%） 使用倾向评分 （PS） 匹配和风险集抽样的组合方法任意选择，以形成对照组 （匹配比例为 1：4）。本研究的主要结果是肌肉减少症的发生，如亚洲肌肉减少症工作组 （AWGS） 2019 年共识所定义。次要结局包括肌肉质量低（DXA 男性 < 7.0 kg/m2，女性低于 5.4 kg/m2）、骨骼肌力量降低（男性握力 < 28 kg，女性 < 18 kg）和身体机能不佳（6 分钟步行速度 < 1.0 m/s）。 使用具有时变协变量的 Cox 比例风险模型估计他汀类药物的使用与结果之间的关系，其中包括他汀类药物的使用状况和其他变量 （双尾 p < 0.05 被认为具有统计学意义）。进行了基于年龄和性别的分层，以及 5 项敏感性分析——包括倾向评分重叠加权和阴性对照。结果应用 PS 匹配后，我们确定了 342 例他汀类药物启动剂和 1294 例非他汀类药物使用者，各组间基线特征均衡。使用他汀类药物与发生肌肉减少症的风险增加 （调整后的风险比 [aHR]，1.43 [95% CI，0.86,2.36]）、肌肉力量减少 （aHR，1.11 [95% CI，0.80， 1.54]）、肌肉质量减少 （aHR， 1.09 [95% CI， 0.66， 1.82]） 或身体机能受损 （aHR， 0.73 [95% CI， 0.46， 1.17]） 无关。这些发现在年龄和性别分层以及所有敏感性分析中是一致的。结论他汀类药物的使用与日本社区居住的中老年人肌肉减少症风险升高或肌肉健康受损无关。