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Video: Are Statins Dangerous For Bones? Depends On The Dose
Are statins dangerous for bones? Depends on the dose
It looks like scientists have figured out how statins actually affect bone health and whether they can cause osteoporosis. Their effect on bone appears to be dose-dependent.
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The conclusion that statins can stimulate bone formation was first reached 20 years ago. For example, in 1999, researchers reported in the journal Science that two drugs in this group promote bone formation and increase bone volume in mice and rats. More recent studies have confirmed this effect in humans. In January 2017, the journal Osteoporosis International published the results of a study showing statin use was associated with increased bone mineral density in the hip and lumbar spine.
A new study, published in the journal Annals of the Rheumatic Diseases, suggests that while low doses of statins can help prevent osteoporosis, too much statins can impair bone health.
An analysis of the health data of approximately 8 million Austrian adults found a decrease in the incidence of osteoporosis among those who took up to 10 milligrams a day of statins such as lovastatin, pravastatin, simvastatin or rosuvastatin, compared with those who did not take statins at all.
But the researchers also found that taking statins at 20 milligrams a day or more had a different effect that increased as the dosage was increased. “We were able to demonstrate that treatment with statins at high doses increased the risk of osteoporosis, while low doses of statins were associated with a lower risk of osteoporosis,” says study lead author Michael Leutner of the Medical University of Vienna.
Specifically, people who took 0 to 10 milligrams of simvastatin per day had a 30% lower risk of osteoporosis compared to people not taking statins. On the other hand, people taking 40 to 60 mg of simvastatin per day had a 64% higher risk of osteoporosis compared to those who did not take statins, and those who took 60 to 80 mg per day were at risk 230% higher. The results were similar for other statins.
Exactly how statins affect bones is not yet fully understood. One of the authors of the study suggests that they improve bone formation by increasing the expression of bone morphogenic protein (BMP2), which has osteoprotective effects. Researchers suggest that statins, by lowering the production of cholesterol in the body, may affect the level of sex hormones and, therefore, influence the development of osteoporosis. Cholesterol is the main building block for the production of the hormones estrogen and testosterone. And in relatively high doses, according to the authors, the inhibitory effect of statins on sex hormones may override the osteoprotective effect.
Scientists point out that the risk of osteoporosis, including an increased risk of bone fractures, is especially high in postmenopausal women, since estrogen has an osteoprotective effect, therefore, a decrease in sex hormones in postmenopausal women is a major risk factor for osteoporosis. Low testosterone levels in men have also been linked to low bone mineral density.
Statins have been shown to be effective in lowering the risk of heart attack, stroke and other cardiovascular disease by lowering the level of "bad cholesterol".