Browse > Article
http://dx.doi.org/10.24304/kjcp.2021.31.4.278

The Association between Medication Use for Dyslipidemia and Osteoporosis  

Lee, Hansol (College of Pharmacy, Dongduk Women's University)
Kim, Jongyoon (College of Pharmacy, Dongduk Women's University)
Rhew, Kiyon (College of Pharmacy, Dongduk Women's University)
Publication Information
Korean Journal of Clinical Pharmacy / v.31, no.4, 2021 , pp. 278-284 More about this Journal
Abstract
Background: Osteoporosis is a disease that affects the quality of life and imposes a high socioeconomic burden. Studies have reported that statins, a HMG CoA reductase inhibitor, have a positive or negative effect on osteoporosis. The purpose of this study was to analyze the correlation between statins and osteoporosis risk. Methods: We used the total patient sample data of the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the prevalence of osteoporosis in adult patients of Korea who were diagnosed with dyslipidemia and were prescribed statins at the same time. The odds ratio (OR) according to the intensity and type of statin was used to confirming the prevalence. Results: Among the 1,138,899 patients included in the study, 143,895 patients used statins and 27,524 patients (19.13%) were diagnosed with osteoporosis in the statin group. The OR value of statin group was 0.96 (95% CI 0.94-0.98), confirming that the prevalence of osteoporosis decreased, and a significant decrease was seen in all statin intensity. Some of the moderate-intensity statins rather increased the prevalence of osteoporosis, but atorvastatin and rosuvastatin obtained positive results at both medium- and high-intensity doses, and lovastatin, a low-intensity statin, showed the greatest reduction in the prevalence of osteoporosis. Conclusion: We found that the prevalence of osteoporosis was reduced in the statin group, and there was a constant correlation regardless of gender or age. However, a large, prospective, double-blind and randomized study is needed for a long period of time to demonstrate the effectiveness of statins.
Keywords
Statin; intensity; ezetimibe; dyslipidemia; osteoporosis;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Kazi DS, Penko JM, Bibbins-Domingo K. Statins for primary prevention of cardiovascular disease: review of evidence and recommendations for clinical practice. Med Clin North Am 2017;101(4):689-99.   DOI
2 Compston JE, McClung MR, Leslie WD. Osteoporosis. Lancet 2019;393(10169):364-76.   DOI
3 Horodinschi RN, Stanescu AMA, Bratu OG, Pantea Stoian A, Radavoi DG, Diaconu CC. Treatment with statins in elderly patients. Medicina (Kaunas) 2019;55(11):721.   DOI
4 Johnston CB, Dagar M. Osteoporosis in older adults. Med Clin North Am 2020;104(5):873-84.   DOI
5 Miller PD. Unrecognized and unappreciated secondary causes of osteoporosis. Endocrinol Metab Clin North Am 2012;41(3):613-28.   DOI
6 Strilchuk L, Tocci G, Fogacci F, Cicero AFG. An overview of rosuvastatin/ezetimibe association for the treatment of hypercholesterolemia and mixed dyslipidemia. Expert Opin Pharmacother 2020;21(5):531-9.   DOI
7 Jadhav SB, Jain GK. Statins and osteoporosis: new role for old drugs. J Pharm Pharmacol 2006;58(1):3-18.   DOI
8 Mundy G, Garrett R, Harris S, et al. Stimulation of bone formation in vitro and in rodents by statins. Science 1999;286(5446):1946-9.   DOI
9 Leutner M, Matzhold C, Bellach L, et al. Diagnosis of osteoporosis in statin-treated patients is dose-dependent. Ann Rheum Dis 2019;78(12):1706-11.   DOI
10 Yilmaz A, Arikan O, Dokmetas S. Effects of statins on bone mineral density. Saudi Med J 2006;27(9):1433-5.
11 Horiuchi N, Maeda T. Statins and bone metabolism. Oral Dis 2006;12(2):85-101.   DOI
12 Ferrari S, Bianchi ML, Eisman JA, et al. Osteoporosis in young adults: pathophysiology, diagnosis, and management. Osteoporos Int 2012;23(12):2735-48.   DOI
13 Hamelin BA, Turgeon J. Hydrophilicity/lipophilicity: relevance for the pharmacology and clinical effects of HMG-CoA reductase inhibitors. Trend Pharmacol Sci 1998;19(1):26-37.   DOI
14 Hatzigeorgiou C, Jackson JL. Hydroxymethylglutaryl-coenzyme a reductase inhibitors and osteoporosis: a meta-analysis. Osteoporosis International 2005;16(8):990-8.   DOI
15 Reid IR, Hague W, Emberson J, et al. Effect of pravastatin on frequency of fracture in the LIPID study: secondly analysis of a randomized controlled trial. Lancet 2001;357(9255):509-12.   DOI
16 Eastell R. Treatment of postmenopausal osteoporosis. N Engl J Med 1998;338(11):736-46.   DOI
17 Kim HJ, Koo HS, Kim YS, et al. The association of testosterone, sex hormone-binding globulin, and insulin-like growth factor-1 with bone parameters in Korean men aged 50 years or older. Journal of Bone and Mineral Metabolism 2017;35(6):659-65.   DOI
18 Panday K, Gona A, Humphrey MB. Medication-induced osteoporosis: screening and treatment strategies. Ther Adv Musculoskelet Dis 2014;6(5):185-202.   DOI
19 Carlson BC, Robinson WA, Wanderman NR, et al. The American Orthopaedic Association's Own the Bone® database: a national quality improvement project for the treatment of bone health in fragility fracture patients. Osteoporos Int 2018;29(9):2101-9.   DOI
20 Committee of Clinical Practice Guideline of the Korean Society of Lipid and Atherosclerosis (KSoLA). Korean Guidelines for the Management of Dyslipidemia, 4th ed. Available from https://www.lipid.or.kr/bbs/index.html?code=care&category=&gubun=&page=1&number=957&mode=view&keyfield=&key=. Accessed September 07, 2021.
21 Xu Y, Wu Q. Decreasing trend of bone mineral density in US multiethnic population: analysis of continuous NHANES 2005-2014. Osteoporos Int 2018;29(11):2437-46.   DOI
22 Ruanpeng D, Ungprasert P, Sangtian J, Harindhanavudhi T. Sodiumglucose cotransporter 2 (SGLT2) inhibitors and fracture risk in patients with type 2 diabetes mellitus: a meta-analysis. Diabetes Metab Res Rev 2017;33(6):e2903.   DOI
23 Lane NE. Epidemiology, etiology, and diagnosis of osteoporosis. Am J Obstet Gynecol 2006;194(2 Suppl):S3-11.   DOI
24 Lorentzon M. Treating osteoporosis to prevent fractures: current concepts and future developments. J Intern Med 2019;285(4):381-94.   DOI
25 Zethraeus N, Borgstrom F, Strom O, Jonsson B. Cost-effectiveness of the treatment and prevention of osteoporosis--a review of the literature and a reference model. Osteoporos Int 2007;18(1):9-23.   DOI
26 Lin SM, Wang JH, Liang CC, Huang HK. Statin use is associated with decreased osteoporosis and fracture risks in stroke patients. J Clin Endocrinol Metab 2018;103(9):3439-48.   DOI
27 Lin TK, Chou P, Lin CH, Hung YJ, Jong GP. Long-term effect of statins on the risk of new-onset osteoporosis: a nationwide population-based cohort study. PLoS One 2018;13(5):e0196713.   DOI
28 Pena JM, Aspberg S, MacFadyen J, Glynn RJ, Solomon DH, Ridker PM. Statin therapy and risk of fracture: results from the JUPITER randomized clinical trial. JAMA Intern Med 2015;175(2):171-7.   DOI
29 An T, Hao J, Sun S, et al. Efficacy of statins for osteoporosis: a systematic review and meta-analysis. Osteoporos Int 2017;28(1):47-57.   DOI
30 Jadhav SB, Narayana Murthy PS, Singh MM, Jain GK. Distribution of lovastatin to bone and its effect on bone turnover in rats. J Pharm Pharmacol 2006;58(11):1451-58.   DOI