Atorvastatin kullanan hastalarda kas performansının izokinetik test ile değerlendirilmesi

Statins are widely used to lower LDL-cholesterol levels. Mechanism ofaction is inhibition of 3-hydroxy-3-metilglutaril coenzyme A reductase (HMGCoA) which plays a role in the regulation of cholesterol synthesis in endogenousendoplasmic reticulum. Two of the most important side effects are hepatotoxicityand myopathy. Myopathy is rare and characterized by widespread muscle pain,fatigue and increased serum creatine phosphokinase levels. In case of myopathy,if the drug is continued to be taken, rhabdomyolysis may develop with highmortality.In this study we aimed to observe if isokinetic muscle strength is affectedin patients on statin therapy. Twenty-six patients on atorvastatin for 3 months with20 mg / day were evaluated before and after treatment. Sense of muscle weaknesson visual analogue scale, serum creatine phosphokinase levels and strength ofknee muscles by isokinetic test were evaluated. We aimed to quantitate the degreeof possible myopathy by means of isokinetic testing.As a result, two patients had myalgia after treatment, and asymptomaticelevation of serum creatine phosphokinase was observed in one patient. Beforeand after the treatment, there was no statistically significant difference in visualpain scores and serum creatine phosphokinase levels. In addition, there was nocorrelation between serum creatine phosphokinase levels and visual pain scores.After treatment; flexion and extension peak torque values at 60 ° / s velocityvalues, and total work values in flexion and extension by 180 ° / s speed, was47significantly reduced compared to values before treatment. The effect of statins onmitochondrial phosphorylation and type 1 and type 2a fibers which mainly useoxidative path in the production of energy, may explain these results.In conclusion, in this study, 20 mg / day atorvastatin for 3 months causedecrease in isokinetic muscle strength without causing an increase in serumcreatine phosphokinase levels and clinically significant myopathy.