Statins decrease bone turnover in postmenopausal women: a cross-sectional study

• Published in: European journal of clinical investigation Vol. 32; no. 8; pp. 581 - 589
• Main Authors: Rejnmark, L., Buus, N. H., Vestergaard, P., Andreasen, F., Larsen, M. L., Mosekilde, L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-08-2002; Blackwell Publishing Ltd
• Subjects: Aged; Alkaline Phosphatase - blood; Biochemical bone markers; Biomarkers - blood; bone; Bone Density; Bone Remodeling - drug effects; Calcium - metabolism; Collagen - blood; Collagen Type I; Cross-Sectional Studies; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia - drug therapy; Hypercholesterolemia - metabolism; Linear Models; Middle Aged; Osteocalcin - blood; osteoporosis; Parathyroid Hormone - blood; Peptides - blood; postmenopausal women; Postmenopause - metabolism; Simvastatin - therapeutic use; statins
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1046/j.1365-2362.2002.01024.x

Background Statins have been suggested as potential agents in the management of osteoporosis. Reviews of medical records have shown an increased bone mass and some studies have shown a reduced occurrence of fractures in subjects on long‐term treatment with statins. We studied the effects of treatment with statins on calcium homeostasis, bone turnover and bone mineral density.
Design In a cross‐sectional design, plasma levels of parathyroid hormone (PTH) and biochemical markers of bone turnover, bone mineral density (BMD) and body composition (fat‐ and lean tissue‐mass) were measured in 140 postmenopausal women who had been treated with a statin for more than 2 years (median 4 years) and compared to 140 age‐ and gender‐matched, population‐based controls.
Results Plasma levels of bone turnover markers were lower in the statin‐treated subjects than in the controls: osteocalcin (−9%, P = 0·03), bone‐specific alkaline phosphatase (−14%, P < 0·01), and C‐terminal telopeptide of type I collagen (−11%, P < 0·01). On the other hand, plasma PTH levels were 16% higher in the statin‐treated subjects than in the controls (P < 0·01). However, body composition and BMD at the lumbar spine, hip, forearm and whole body did not differ between the two groups. No correlation could be demonstrated between changes in biochemical quantities and dose or duration of statin use.
Conclusion Our data show that statins affect the function of bone cells. Most likely, the effect is antiresorptive.