Statin-Intolerant Patients Exhibit Diminished Muscle Strength Regardless of Lipid-Lowering Therapy

Area of Science:

• Cardiology
• Neurology
• Metabolic Disorders

Background:

• Statin-associated muscle symptoms (SAMS) are a common adverse effect of statin therapy, impacting adherence and cardiovascular risk.
• The precise relationship between SAMS, muscle performance, and body composition remains incompletely understood.

Purpose of the Study:

• To investigate differences in body composition and muscle strength between statin-intolerant (SI) and statin-tolerant (ST) patients.
• To assess the long-term impact of statin intolerance on muscle quality and body composition.

Main Methods:

• Retrospective analysis of 148 SI and 145 age/sex-matched ST patients from a lipid clinic.
• Evaluated cardiovascular risk factors, lipid profiles, BMI, body composition (BIA), and muscle quality (handgrip/skeletal muscle mass) at baseline and after a mean 45-month follow-up.

Main Results:

• SI patients exhibited higher baseline BMI, cholesterol, and triglycerides. Over follow-up, SI patients showed increased BMI and persistently higher LDL-cholesterol.
• At follow-up, SI patients had higher fat mass percentage. Muscle quality, assessed by handgrip strength standardized for skeletal muscle mass, was significantly lower in SI patients, especially in the non-dominant arm.
• Elevated creatine kinase levels at baseline remained higher in SI patients who did not restart statins after re-challenge.

Conclusions:

• Statin intolerance is clinically associated with diminished muscle quality, particularly affecting less-exercised limbs.
• These findings highlight a potential link between statin use, muscle health, and body composition, warranting further investigation.