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

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

Subjects and methods: 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.

Results: 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).

Conclusions: 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.