Effect of HMG-CoA reductase inhibitors (statins) on bone mineral density

Recent studies have suggested that 3-hydroxy-3-methylglutaryl - coenzyme A (HMG-CoA) reductase inhibitors (statins) can increase the bone mineral density (BMD). Our objective was to determine if patients on statin drugs were more likely to have a greater bone mineral density and lower risk of osteoporosis than patients not taking these drugs. A computerized pharmacy system provided complete medication dispensing records for the 983 patients (697 men and 286 women) referred for bone mineral density testing at a single Veterans Affairs Medical Center. In an analysis of covariance model that adjusted for age, body mass index, race, and vitamin use, men using statin drugs were more likely to have a greater BMD of the spine (p < 0.005). The mean difference (effect size) was 0.05 g/cm2 (95% confidence interval of [CL] 0.02-0.09), about 5.3% greater BMD. In women, the association was not significant. The risk of osteoporosis (defined as a T-score < or = -2.5) was determined using logistic regression analysis after adjustment for potential confounding variables. Although not statistically significant, men who received statin drugs for more than 2 yr were approximately half as likely to develop osteoporosis (odds ratio [OR] =.55, 95% CI = 0.28-1.08). A similar effect was observed in women taking statins for any length of time (OR = 0.36, 95% CI = 0.12-1.07). This study suggests that statin drugs may decrease osteoporosis risk, warranting a randomized controlled trial.