Treatment of dyslipidemia with statins and physical exercises: recent findings of skeletal muscle responses.

Statin treatment in association with physical exercise practice can substantially reduce cardiovascular mortality risk of dyslipidemic individuals, but this practice is associated with myopathic event exacerbation. This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords "statin" AND "exercise" AND "muscle", restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises. Moderate physical training, in turn, when associated to statins does not increase creatine kinase levels or pain reports, but improves muscle and metabolic functions as a consequence of training. Therefore, it is suggested that dyslipidemic patients undergoing statin treatment should be exposed to moderate aerobic training in combination to resistance exercises three times a week, and the provision of physical training prior to drug administration is desirable, whenever possible.

Treatment of Dyslipidemia with Statins and Physical Exercises: Recent Findings of Skeletal Muscle Responses / Tratamento das Dislipidemias com Estatinas e Exercícios Físicos: Evidências Recentes das Respostas Musculares

Statin treatment in association with physical exercise practice can substantially reduce cardiovascular mortality risk of dyslipidemic individuals, but this practice is associated with myopathic event exacerbation. This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords “statin” AND “exercise” AND “muscle”, restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises. Moderate physical training, in turn, when associated to statins does not increase creatine kinase levels or pain reports, but improves muscle and metabolic functions as a consequence of training. Therefore, it is suggested that dyslipidemic patients undergoing statin treatment should be exposed to moderate aerobic training in combination to resistance exercises three times a week, and the provision of physical training prior to drug administration is desirable, whenever possible.

A associação do tratamento medicamentoso por estatinas com a prática de exercícios físicos pode reduzir substancialmente o risco de mortalidade cardiovascular de indivíduos dislipidêmicos, porém sua realização vem sendo associada à exacerbação de quadros miopáticos. O presente trabalho teve como objetivo apresentar os resultados mais recentes da literatura específica sobre os efeitos da associação de estatinas ao exercício físico na musculatura esquelética. Para tanto, realizou-se levantamento da literatura nas bases de dados PubMed e SciELO, utilizando a combinação dos unitermos: “estatina/estatinas” AND “exercício” AND “músculo” (“statin” AND “exercise” AND “muscle”), sendo selecionados apenas artigos originais publicados entre janeiro de 1990 e novembro de 2013. Foram analisados 16 artigos que avaliaram o efeito da associação das estatinas com exercício agudo ou crônico na musculatura esquelética. Os resultados dos estudos apontaram que atletas podem experimentar efeitos deletérios na musculatura esquelética quando do uso de estatinas, visto que os quadros de exacerbação da lesão muscular pelo exercício foram mais frequentes com treinamento intenso ou exercícios agudos excêntricos e extenuantes. O treinamento físico moderado, por sua vez, quando associado às estatinas, não aumenta os relatos de dor nem os níveis de creatina quinase, além de acarretar ganhos nas funções musculares e metabólicas advindas do treinamento. Sugere-se, portanto, que pacientes dislipidêmicos em tratamento com estatinas sejam expostos ao treinamento físico aeróbio combinado a exercícios resistidos, de intensidade moderada, em três sessões semanais, sendo que a oferta do treinamento físico previamente à administração do tratamento medicamentoso, quando possível, faz-se desejável.

[Creatine kinase BB activity in the serum and bronchial aspirate of preterm newborns with respiratory distress syndrome]. / Actividad de la isoenzima CKBB en suero y broncoaspirado de recién nacidos pretérmino con síndrome de distrés respiratorio.

OBJECTIVE: The aim of this study was to test the utility of serum creatine kinase (CK) isoenzyme determinations as a marker of tissue injury in preterm newborns with respiratory distress syndrome (RDS). PATIENTS AND METHODS: Two groups of neonates were studied, 26 suffering from RDS who required mechanical ventilation and 20 healthy newborns with gestational ages, hours of life and birth weights similar to the first group. The activity of CK and its isoenzymes was determined in the bronchial aspirate and serum samples that were obtained before and 24 hours after exogenous surfactant therapy. The isoenzymes were separated by electrophoresis on agarose gel and their activity expressed as a percentage of the total CK. Total proteins were quantified in the bronchial aspirate and CK enzymatic activity expressed in U/mg of protein x 10-3. RESULTS: The CK-BB isoenzyme was significantly increased (p < 0.001) in the serum of infants with RDS compared with the control group. In the bronchial aspirate, the isoenzymatic study showed that the CK-BB isoenzyme represented 98-100% of the total enzymatic CK activity. CONCLUSIONS: The study shows significant differences in the CK isoenzyme patterns of neonates with RDS compared to controls. An increase in serum levels of the CK-BB isoenzyme could be an effective marker of tissue injury in lung disease in the newborn.