Statin Use May Improve Bone Microstructure in Women With Osteoporosis

Statins, pills
Statins, pills
Statin use is associated with better cortical bone characteristics in older women with osteoporosis, but results are dependent upon the potency of the statins.

Study results published in The Journal of Clinical Endocrinology & Metabolism are the first to report an association between statin treatment, bone microstructure, volumetric bone mineral density (BMD), and bone geometry in older women with osteoporosis.

The study investigated associations between statin treatment, volumetric BMD, and bone microstructure. The researchers also examined whether these potential associations were dependent upon other confounding factors, such as physical function. The prospective population-based study included 3028 randomly chosen women (mean age, 77.8 ± 1.6) who exhibited “at least one hip that could be assessed for areal BMD.” Study assessments included anthropometrics and physical function tests; questionnaires to measure medical history, fracture history, and current medication use; dual-energy X-ray absorptiometry to measure areal BMD at the femoral neck; high-resolution peripheral quantitative computed tomography to measure bone microstructure and geometry; and cortical evaluation for further image analysis.

The investigators reported that participants with ongoing (n = 803) had higher body weight, participated in less physical activity, and were more likely to have diabetes and medical histories that included prior stroke, myocardial infarction, and angina pectoris vs participants without ongoing statin treatment. Women receiving statin therapy had worse physical function outcomes compared with participants who were not receiving statins. 

There were significant differences in total hip, femoral neck, and lumbar spine BMD in favor of women in the statin-treated cohort, but these differences became negligible when comparing statin users with matched controls. Comparative analysis between different types of statins showed participants treated with more potent statins (atorvastatin or rosuvastatin) exhibited higher cortical volumetric BMD in both the tibia and radius compared with simvastatin treatment.

Study limitations included a lack of information on statin dosage or treatment duration, a small age range for the study population, and possible medical imbalances between the treatment group and matched control counterparts.

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The researchers concluded that “statin use is associated with better cortical bone characteristics” in older women with osteoporosis, but results are dependent upon the potency of the statins.

Multiple authors declared affiliations with the pharmaceutical industry. Please refer to original reference for a full list of authors’ disclosures.

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Larsson BAM, Sundh D, Mellström D, Axelsson KF, Nilsson AG, Lorentzon M. Association between cortical bone microstructure and statin use in older women [published online November 13, 2018]. J Clin Endocrinol Metab. doi:10.1210/jc.2018-02054