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Statin but not non-statin lipid-lowering drugs decrease fracture risk: a nation-wide case-control study.

L Rejnmark1, P Vestergaard, L Mosekilde

  • 1Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus Sygehus, Tage Hansens Gade 2, Aarhus C, DK-8000 Denmark. rejnmark@post6.tele.dk

Calcified Tissue International
|July 27, 2006
PubMed
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The use of non-pravastatin statins is linked to a lower risk of fractures, particularly hip fractures. This specific association challenges the idea that a general "healthy user effect" explains reduced fracture risk in all lipid-lowering drug users.

Area of Science:

  • Pharmacology and Bone Health
  • Epidemiology and Drug Safety

Background:

  • Conflicting research exists on the relationship between lipid-lowering drugs and fracture risk.
  • Some studies show no effect of statins on bone mineral density, suggesting potential selection bias (healthy drug user effect).

Purpose of the Study:

  • To investigate the association between various lipid-lowering drugs and fracture risk.
  • To differentiate the effects of different classes of lipid-lowering medications on bone health.

Main Methods:

  • A case-control study design was employed.
  • 124,655 fracture cases were compared with 373,962 age- and gender-matched controls.
  • Computerized registers were used to link drug use data with fracture data and confounders.

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Main Results:

  • Statin use was associated with a reduced risk of any fracture (adj. OR 0.87) and hip fractures (adj. OR 0.57).
  • Increased statin dosage correlated with a lower hip fracture risk across different demographics.
  • No reduced fracture risk was observed with pravastatin or non-statin lipid-lowering drugs.

Conclusions:

  • The observed reduction in fracture risk is specifically linked to users of non-pravastatin statins.
  • The findings do not support the healthy drug user effect hypothesis for statin users and reduced fracture risk.