Re: Statins and muscle damage

Jason Johnson wrote:
In article <1148887080.982841.82370@xxxxxxxxxxxxxxxxxxxxxxxxxxxx>, "Andrew
B. Chung, MD/PhD" <andrew@xxxxxxxxxxxxxx> wrote:
Jason Johnson wrote:
> In article <1148868097.679979.110770@xxxxxxxxxxxxxxxxxxxxxxxxxxx>, "Andrew
> B. Chung, MD/PhD" <andrew@xxxxxxxxxxxxxx> wrote:
> eml wrote:
> > > > David Rind wrote:
> > >
> > > > A couple of caveats, of course: A. Although there may be no
> > > > current injury, the future remains unpredictable, and muscle
> > > > symptoms (which are nearly always mild and reversible) may arise
> > > > at any time.
> >
> > the following may interest those responding to this OP:
> >
> > "Statins may alter the response of muscle to exercise stress by
> > altering the action of the UPP, protein folding, and catabolism,
> > disrupting the balance between protein degradation and repair. "
> >
> > Atherosclerosis and Lipoproteins
> >
> > Changes in Ubiquitin Proteasome Pathway Gene Expression in Skeletal
> > Muscle With Exercise and Statins
> > Maria L. Urso; Priscilla M. Clarkson; Dustin Hittel; Eric P. Hoffman;
> > Paul D. Thompson
> >
> > >From the Department of Exercise Science (M.L.U., P.M.C.), University of
> >
> > Massachusetts, Amherst, Mass; the Division of Cardiology (P.D.T.),
> > Henry Low Heart Center, Hartford Hospital, Hartford, Conn; and the
> > Research Center for Genetic Medicine (D.H., E.P.H.), Children's
> > National Medical Center, Washington DC.
> >
> > Objective- Statins are safe medications but have side effects
> > including myalgia and rhabdomyolysis. How statins provoke muscle damage
> >
> > is not known, but this effect is exacerbated by exercise.
> >
> > Methods and Results- Healthy subjects took Atorvastatin (80 mg/daily)
> > or placebo for 4 weeks. Biopsies of both vastus lateralis muscles were
> > performed 8 hours after eccentric exercise (known to result in muscle
> > soreness and damage) of the left leg at baseline and the right leg
> > after statin/placebo treatment. Gene expression was determined using
> > Affymetrix GeneChips, and selected genes confirmed by polymerase chain
> > reaction (qRT-PCR). Atorvastatin had little effect on gene expression
> > at rest. When combined with exercise, 56 genes were differentially
> > expressed with 18% involved in the ubiquitin proteasome pathway (UPP)
> > and 20% involved in protein folding and catabolism, and apoptosis.
> >
> > Conclusion- This is the first investigation to our knowledge to
> > implicate involvement of the UPP in skeletal muscle in response to
> > combined exercise and statin treatment, possibly explaining the onset
> > of myalgia with exertion. Statins may alter the response of muscle to
> > exercise stress by altering the action of the UPP, protein folding, and
> >
> > catabolism, disrupting the balance between protein degradation and
> > repair.
> >
> > Statins are safe medications but have side effects including myalgia
> > and rhabdomyolysis. How statins provoke muscle damage is not known, but
> >
> > this effect is exacerbated by exercise. This is the first investigation
> >
> > to our knowledge to implicate involvement of the UPP in skeletal muscle
> >
> > in response to combined exercise and statin treatment, possibly
> > explaining the onset of myalgia with exertion. Statins may alter the
> > response of muscle to exercise stress by altering the action of the
> > UPP, protein folding, and catabolism, disrupting the balance between
> > protein degradation and repair.
>
> Yes, I am familiar with the concerns about long term statin use.
>
> Again, the goal is to eventually get folks off the statins and this
> happens for most when they become lean and trim.
>
> Andrew,
> As usual, you are 100% correct.
> Jason

All glory and praise belongs to GOD, Whom I love with all my being.

Many thanks to GOD for your kind heart.

Andrew,
Do you think that GP doctors should or should not conduct serum creatinine
and CPK tests on their patients that take statins to determine whether the
patients are or are not developing Rhabdomyolysis? I once read an article
that was written by the wife of man that developed statin induced Rhabdo.
He lost the use of his arms, legs and kidneys. I don't understand why at
least some
doctors don't bother to conduct the tests mentioned above to keep people
from developing Rhabdo. --perhaps they feel that since Rhabdo is a rare
disease--they don't have to worry about it.
Jason

They should be vigilant about the possibility. They should also be
given the lattitude to decide how to best take care of their patients.

Prayerfully in Christ's amazing love,

Andrew
http://tinyurl.com/jjl29

.

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