Source: MedWire News
Simvastatin treatment is associated with an increase in bone mineral density (BMD) in hyperlipidemic individuals with osteopenia, results of a randomized controlled trial show.
The investigators say their findings indicate that bone-building is a pleiotropic effect of statin therapy and support the adjuvant use of these agents for the prevention of bone loss in patients with hyperlipidemia.
Somlak Chuengsamarn (Srinakharinwirot University, Nakornnayok, Thailand) and team investigated recent reports that statin therapy enhances the expression of bone morphogenetic proteins (BMP), resulting in enhanced osteoblast differentiation and bone formation and reduced osteoclast activity.
They recruited 212 patients with hyperlipidemia and osteopenia and randomly assigned them to receive lipid-lowering treatment with either a statin (simvastatin 40–80 mg/day) or a non-statin (gemfibrozil or fibrate) drug.
Simvastatin was chosen as the statin because it is lipophilic and has been shown in many studies to increase the production of BMP2, note the authors.
After 18 months of treatment, levels of N-terminal propeptide of procollagen type 1 – a marker of bone formation – had increased markedly in the statin treatment group but fallen slightly in the non-statin group (16.56 versus –2.59 ng/ml). The between-group difference was statistically significant.
Levels of serum c-telopeptide of type 1 collagen – a marker of bone resorption – had decreased in both treatment groups but the magnitude of decrease was larger in the statin group versus the non-statin group (–0.30 vs –0.23 ng/ml).
Finally, BMD at the distal radius – a known correlate of fracture risk – had increased significantly in the statin group but decreased in the non-statin group (0.05 vs –0.01), leading to a statistically significant difference between the treatment groups.
Writing in the journal Bone, Chuengsamarn et al say their study demonstrates that 18 months’ treatment with moderate-to-high-dose simvastatin is “clearly better than non-statin treatment in regards to bone metabolism.”
They add: “Our study showed that statin therapy is better on lipid management over non-statin therapy, but furthermore, lipophilic type statins may offer better overall bone metabolism as it relates to BMD.
“We support future larger and more long-term studies which would answer if there is a dose-effect to the lipophilic statins and whether these forms of statins are of clear benefit in either preventing and/or slowing bone loss in the aging osteoporotic population.”