Can statin drugs prevent osteoporosis?
Statin drugs, such as simvastatin (Zocor), atorvastatin (Lipitor), and pravastatin (Pravachol), are prescribed to lower cholesterol levels and to reduce your risk of heart disease and stroke. But studies have suggested that these drugs may also stimulate bone formation—a mechanism that could reduce the risk of osteoporosis by offsetting bone loss in postmenopausal women. A recent study published in the Archives of Internal Medicine confirms that statin drugs taken for high cholesterol may indeed reduce the risk of osteoporotic fractures in postmenopausal women.
About the study
Researchers at the University of Melbourne, Australia, studied 1375 women between the ages of 50 and 95 who were participating in the Geelong Osteoporosis Study—an ongoing study of osteoporosis in southeastern Australia. For this sub-study, they enrolled 573 women who had suffered a fracture between February 1994 and February 1996 (cases) and 802 women of similar ages without any fractures during that time period (controls). The researchers identified fracture cases through radiology records at the two radiology practices in the Geelong region.
The women completed questionnaires about medication use, diet, and lifestyle factors, such as smoking, exercise, and alcohol consumption. The researchers compared the number of fractures among those who took statins with the number of fractures among those who did not.
Women who took statin drugs were 60% less likely to experience a fracture than women who did not take statin drugs. Surprisingly, however, an increase in bone mineral density did not seem to account for this reduction in fracture risk, so the mechanism by which statins seems to protect against fractures remains unclear.
The results remained roughly the same when the researchers adjusted their calculations to account for other factors that could affect fracture risk, such as age, weight, calcium and vitamin D intake, hormone replacement therapy, exercise, alcohol consumption, and smoking.
There are limitations to this study, however.
As with any study that relies on participants to recall medication use and dietary and lifestyle habits, the possibility exists that their recall was not quite accurate. In addition, this study does not provide information about how statins may be able to prevent fractures in postmenopausal women. Finally, these results may not apply to women of other ethnic and racial groups not represented in the Geelong region of southeastern Australia.
How does this affect you?
Does this mean that you should take statins solely to prevent osteoporosis? It's too early to say, particularly because we don't know how statins prevent fractures, if in fact they do. These findings confirm earlier research indicating that statins may prevent fractures, but they also conflict with this same research by suggesting that the mechanism may not be related to increasing bone mineral density. More research is needed to confirm the protective effects of statins and understand how they may prevent fractures.
Both osteoporosis and high cholesterol are concerns for postmenopausal women. This research suggests that older women who need to take statin drugs to lower their cholesterol levels may gain an added benefit of protection against osteoporosis. Does this mean if you take statins you don't need to worry about osteoporosis? Not necessarily. You should still take a comprehensive approach to osteoporosis prevention by eating plenty of foods with calcium, doing weight-bearing exercise regularly, refraining from smoking, and consulting your health care provider about your risk factors and your medication and supplement options.
Foods with the most calcium include:
- Calcium fortified foods, such as orange juice, breakfast cereals and cereal bars, tofu, and soy milk
Pasco JA, et al. Statin use, bone mineral density, and fracture risk. The Geelong Osteoporosis Study.
Archives of Internal Medicine . March 11, 2002;162:537-541.
Last reviewed Mar 12, 2002 by ]]>Richard Glickman-Simon, MD]]>
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