Bone turnover markers in statin users: a population-based analysis from the Camargo Cohort Study

To analyze the effects of statin use on bone turnover markers (BTM), in participants from a large population-based cohort.

Cross-sectional study that included 2431 subjects (1401 women and 930 men) from the Camargo Cohort. We analyzed the differences in serum BTM between statin or non-statin users, by means of a generalized linear model, adjusted for a wide set of covariates and stratified by diabetes status. We also studied the effect of the type of statin, dose, pharmacokinetic properties, and length of treatment, on BTM.

Five hundred subjects (21%) were taking statins (273 women and 227 men). Overall, they had lower levels of aminoterminal propeptide of type I collagen (PINP) and C-terminal telopeptide of type I collagen (CTX) than non-users (p<0.0001). BTM levels were significantly lower in diabetic women using statins, than in female non-statin users with diabetes. In men, we found similar results, but only for CTX. All the statins users had lower levels of BTM than non-users, except subjects taking fluvastatin that showed slightly higher values. In the whole sample, no differences between dose or drug-potency were noted regarding BTM. When comparing with non-statin users, only subjects taking lipophilic statins had lower BTM levels (p<0.0001). Serum CTX levels were lower in women using statins for more than 3 vs. 1-3 years (p=0.006).

In a large population-based cohort, serum BTM were lower in participants taking statins than in non-users, and this effect was modulated by diabetes status. Overall, this decrease in BTM was more evident in subjects receiving the more lipophilic statins, especially when using for more than 3 years.