E hoʻonāukiuki anei nā statins i ka maʻi maʻamau maʻa?

ʻO nā statins, e kuhikuhi pinepine ʻia e hoʻohaʻahaʻa i ka cholesterol, hoʻonui i ka hōʻemi o ka maʻi type 2 a 30%. Ua hūʻike nā hopena o nā hoʻokolohua hou nei i ka ninaninau o nā kūkākūkā ʻana i ka honua o ka lāʻau lapaʻau i.

ʻO nā statins kekahi o nā lāʻau lapaʻau ākea loa i ka USA. I hope i ka makahiki 2012, ma kahi o kahi hapaha o ka nui o ka lehulehu o ka US ma mua o 40 mau a ua lawe pinepine i ka lāʻau kolane-hoʻohaʻahaʻa i ka lāʻau, ma ka nui o nā hihia - statins I kēia lā, ua hoʻonui kēia helu i ka 28% (ʻoiai ua kuhikuhi ʻia i kahi nui nui o ʻAmelika).

ʻO nā statins hoʻohaʻahaʻa i ke kolamu koko ma ka hoʻohaʻahaʻa ʻana i kāna hana e ka ate. Hoʻopili lākou i ka enzyme hydroxymethylglutaryl-coenzyme A-reductase i loko, aia i pili i ka hana o ka cholesterol.

Eia kekahi, hoʻēmi ka statins i ka hoʻololi ʻana a me ke kaumaha o ka oxidative. Hāʻawi i kēia mau hopena āpau i lawe ʻia, e manaʻo kekahi i nā statins e hōʻemi i ka hopena o ka maʻi maʻi type 2.

Eia naʻe, ʻo nā hōʻike mai ka hoʻonui ʻana o ka nui o nā haʻawina e hōʻike ana i ka ʻē aʻe - ʻo ka hoʻohana mau ʻana i ka statins e hoʻonui i ka nui o ka maʻi diabetes type 2. Ua hoʻopuka hou ʻia ka haʻawina like mua ma 2008. ii.

Ma ka pane iā ia, ua hana koke ʻia kekahi mau noiʻi, kahi o kēlā (ma 2009) i ʻōlelo ai, e like me kā kā lākou ʻano, ʻaʻohe hopena kumu o ka statin i ka pili ʻana i ka maʻi hānai a no laila pono nā haʻawina hou iii, a me kekahi mau (ma 2010 ) - - aia kekahi wahi e hoʻonui ai i ka loaʻa o ka maʻi diabetes, akā he mea koʻikoʻi loa iv (e like me ka hoʻohālikelikeʻana i nā hualoaʻa e nā manaʻo i kākoʻo ʻia kekahi mau noiʻi e nā ʻoihana lapaʻau iho - ʻo ka mea haʻi'ōlelo.

E ʻike ai i ke kūlana maoli, ua hoʻoholo nā mea noiʻi mai ke Albert Einstein College of Medicine i New York e hoʻokokoke i ka pilikia ma kahi ʻano ʻokoʻa a neʻe ʻia i ka poʻe momona, a no laila, me ka nui o ka pilikia o ka hoʻomohala ʻana i ka maʻi diabetes 2. Ua hoʻohana pū kekahi hui o nā kānaka ʻepekema i nā ʻikepili maʻamau mai ka United States Diabetes Prevention Program (DPPOS). Ma ka holoʻokoʻa, ua alakaʻi ka hoʻohana ʻana i nā statins i ka hoʻonui ʻana i ka 36% o ka ulu ʻana o ka maʻi maʻi type 2. ʻO ke kumu wale nō i kānalua ai i kēlā mau koina lahilahi e pili ana i ka helu, ua kau ʻia nā statins e pili ana i ka loiloi a ka mea maʻi e ka kauka, a no laila ʻaʻole hoʻokaʻawale ʻia nā poʻe komo. Ua paʻi ʻia nā hopena ma BMJ Open Diabetes Research and Care v.

Ua ʻōlelo ikaika ka hui o nā kānaka ʻepekema i nā maʻi maʻi kiʻekiʻe e kuhikuhi ʻia nei i nā statins no ka pale ʻana i nā maʻi cardiovascular e kiaʻi mau i kā lākou glucose a alakaʻi i ke ola olakino.

Ma lalo o ka hopena o kēlā 'ike, i ka makahiki 2012, ua hoʻopuka ka US Food and Drug Administration i kahi ʻōpilikia e pili ana i ka hiki ke hoʻonui nui ʻia o ka maʻi maʻi i ka poʻe maʻi e lawe ana i ka lāʻau hoʻohiolo kolesterol a me ka hoʻomau paʻakikī o ka maʻi glycemic i ka poʻe i loaʻa i ka maʻi diabetes vi.

Ma muli o ke kīpē i hōʻike pinepine ʻia nā statins i USA a hōʻemi maoli nei i ka hōʻeha o nā maʻi cardiovascular koʻikoʻi, ʻaʻole i pau nā kūkākūkā e pili ana i nā statins hoʻonāukiuki i ka maʻi maʻi.

Eia naʻe, i kēia manawa, ua ulu ka nui o nā haʻawina e kākoʻo ana i kēia hoʻokūkū e like me ka avalanche:

• "ʻO ka hoʻohana ʻana i nā statins a me ka pilikia o ka ulu ʻana i ka maʻi diabetes," ʻo Barty Chogtu a me Rahul Bairy, World Journal of Diabetes, 2015 vii,
• "Nā ʻatikala a me ka pilikia o ka hoʻoulu ʻana i ka maʻi diabetes," Goodarz Danaei, A. Luis Garcia Rodriguez, Cantero Oscar Fernandez, Miguel Hernan A., Diabetes Care of American Diabetes Association 2013 viii,
• "Hoʻohana ʻo Statin a me ka makeʻana o ka maʻi maʻi," Jill R Crandell, Kiren Maser, Swapnil Rajpasak, RB Goldberg, Carol Watson, Sandra Foo, Robert Ratner, Elizabeth Barrett-Connor, Temproza ​​Marinella, BMJ Open Diabetes Research and Care, 2017 ix,
• "Rosuvastatin no ka pale ʻana i nā hanana vascular ma nā kāne a me nā wahine me ka C C reactive protein," Paul M. Ridker, Eleanor Danielson, Francisco HA Fonseca, Jacques Genest, Antonio M. Gotto, John JP Castelein, Wolfgang Cohenig, Peter Libby, Alberto J Lorenzatti, Jean G. MacPheiden, Borg G. Nordeard, James Shepherd, The New England Journal of Medicine, 2008 x,
• "ʻO ka hoʻohana ʻana o statins i hoʻonui i ka hopena o ka maʻi maʻamau ʻo type," ʻo Jack Woodfield, Diabetes.co.uk, 2017 xi
• "Kahu-i hoʻohālikelike ʻia i ka hopena a me nā hopena o nā lāʻau lapaʻau", Umme Ayman, Ahmad Najmi a me Rahat Ali Khan, ka Nūpepa o ka Pharmacology a me ka Pharmacotherapeutics, 2014 xii.

He hoihoi hoihoi loa ka ʻatikala hope. Kuhi ʻo ia i nā ʻike i ka hopena o ka maʻi diabetes ma lalo o ke kaomi o nā statins mai ka 7% a 32%, ma muli o ke ʻano o statin, kona ʻano a me kona makahiki o ka mea maʻi. Ua ʻike nā ʻepekema ʻepekema e pinepine ka statins i ke kō a me ka palupalu i kāna papa i ka pākeke. Kuhi ʻia nō hoʻi ka ʻatikala i kahi ʻano hiki ke hoʻonāukiuki i ka maʻi type 2.

keʻano o ka haʻahaʻa o ka puʻupuʻu e ʻike i ka hoʻēmi ʻana me ka hoʻēmi ʻana i ka hana o ka kolamu ma ka ʻōpio, hoʻēmi ʻia hoʻi nā statins i nā hana insulin a me ka hoʻēmi kino ʻana i nā selela, a, ʻo ia hoʻi, e hoʻolilo i ka puʻuwai a me ka hiki ke hana.

Ua hōʻoia hou kekahi mau ʻepekema ʻepekema nui ka hoʻohana ʻana o nā statins i ka nāwaliwali o ka ʻeha a me ke ʻeha i loko o lākou ma muli o ka nele o ka cholesterol:

• "ʻO ka pilina ma waena o nā statins a me nā hana ...", Richard E. Deichmann, Carl Jay Lavi, Timothy Asher, James D. Dinicolantonio, James H. O'Keefe lāua ʻo Paul D. Thompson, ka Nupepa Ochsner, 2015 xiii,
• "ʻO ka hopena o nā statins i ka ʻoi maʻa: ikaika, myopathy, a me ka ikaika o ka hoʻo," Bet Parker, Paul Thompson, Hoʻomaopopo a me nā ʻĀina Hoʻoikaika Sports, 2012 xiv,
• "Hoʻomaʻamaʻa ʻia ke olakino mai nā lāʻau statin?", Ed Fiz, The New York Times, 2017 xv.

Eia kekahi, ʻike pinepine ʻia nā ʻatikala e hoʻonui maoli ana ka statins i ka hōʻeha o nā maʻi a nā maʻi Parkinson, i kū'ē ʻole i nā kuhi o nā kumu mua i ka ʻae ʻana i ka xvi xvii xviii xix.

Nawai e pono ai nā statins?

Hāʻawi i ka nui o ke kino o nā hōʻike ʻepekema e pili ana i nā hopena koʻikoʻi o nā statins, a nīnau kekahi mau mea lapaʻau e noiʻi i nā kauka a me nā mea maʻi e nīnau iā lākou iho inā ʻoi paha ka pōmaikaʻi o ka hoʻohana ʻana i nā statins i ko lākou hopena maikaʻi ʻole a ʻaʻole paha.

No laila, no ka mea, inā he maʻi maʻi ka maʻi me ka nui o ka kolamu o ka kolamu ma kona koko, a laila pono paha ia e lawe i nā statins, no ka mea, inā make paha ʻo ia i kēlā me kēia manawa. Eia kekahi, pono e hoʻomanaʻo i ka maʻi maʻi o ka maʻi ʻaʻole e kū ka mea i loko o ka hopena o ka 100%. Inā ʻaʻole kiʻekiʻe loa ka kolamu a ka mea maʻi a nui ka ʻoluʻolu o ka naʻau o ka mea maʻi, a laila nō paha e hele ia i ka papa ʻaina a hoʻomaʻamaʻa. Eia naʻe, ma kēia hihia, pono e noʻonoʻo ka hō ʻole e lawe i nā statins i ka kūkā ʻana me ke kauka a hana i nā hana me ka mālama pono. Ma kahi kikoʻī, ʻo ka ʻatikala "ʻaoʻao hopena o ka statin: kaupaona i nā pono a me nā pilikia" o nā limahana ʻo Mayo Clinic xx e kāhea no kēlā ʻano.

ʻO nā palapala ʻē aʻe, e like me, ka mea, ʻo Aspirin vs. Statins, e ʻike i kahi ala e puka ai i ka hoʻololi ʻana i nā statins me nā aspirin no nā maʻi maʻi ʻole. ʻAʻole e like i nā statins, ʻaʻole i hoʻohaʻahaʻa ka aspirin i ka kolamu koko, akā hoʻoheheʻe wale i ke koko, ke pale aku i nā palupalu o ke kolamu mai ka pili ʻana i nā lolo koko. ʻOiai e kākoʻo kekahi mau loea i kēia ʻike, ʻike ka poʻe ʻaʻole hiki i ka aspirin ke pani i kahi no nā xxi statins.