The aim of the study was to evaluate the effects of simvastatin therapy on bone mineral density in hypercholesterolemic postmenopausal women. Fifty-three women, mean age 62,92 +6,08 years treated at the Institute for Treatment and Rehabilitation Niška Banja were included into this study. All patients were divided into two groups: I group - 32 women with total cholesterol level (Hol≥7,8 mmol/l) and II control group - 21 women with total cholesterol less than 7,8 mmol/l. Triglycerides (Tg), total cholesterol (Hol), HDL and LDL cholesterol (HDL-C and LDL-C) were determined. Bone mineral density (BMD) was determined on the lumbar spine (LlL4), by “LUNAR DPX” densitometer. The results were expressed as absolute values (g/cm2) and T score. All patients were treated with lifestyle and dietary modification, while patients in group I were treated with 20 mg of simvastat per day. Biochemical markers and bone mineral density were determined at the start and 12 months after. Simvastatin therapy 20mg⁄day significantly reduced Hol (-12,68%; p<0,01) and LDL-C (-17,99%; p<0,005) levels after 12 months of follow-up. The concentration of TG and HDL-C showed insignificant changes. In II group, there were no significant changes in lipid parameters after 12 months of hypolipemic diet regimen. Increase in BMD +2,81%, (NS) was registered in I group, while decrease in BMD -3,45% (NS) was reported in II group. There was an inverse correlation between BMD changes and LDLC (r=-0,08; p=0,686) in the patients on statin therapy compared to I group (r=0,166, p=0,626). Also, in the same group, an inverse correlation between BMD and Hol (r=0,144; p=0,476) was reported, which was similar to I group (r=-0,125; p=0,715).These results did not reach statistical significance. Conclusion: Simvastatin therapy showed a positive trend and increase in bone mineral densisty in hypercholesterolemic posmenopausal women after 12 months of follow-up, however, without statistically significant difference.
References
1.
Pedersen TR, Kjekshus J. Statin drugs and the risk of fracture. 4S Study Group. JAMA. 2000;284:1921–2.
2.
Satyawan BJ, Girish KJ. Statins and osteoporosis. JPP. 2006;58:3–18.
3.
Lane NE, Rehman Q. Osteoporosis in the rheumatic disease patient. Lupus. 2002;11:675–9.
4.
Hatzigeorgiou CĆ, Jackson JL. Hydroxymethyl-gluta ryl-coenzyme A reductase inhibitors and osteoporo sis: a meta-analysis. Osteoporosis Int. 2005;16:990–8.
5.
Rejinmark L, Buus NH, Vestergaard P. Statins decrease bone turnover in postmenopausal women: A cross sectional study. Eur J Clin Invest. 2002;32:581–9.
6.
Montagnani A, Gonnelli S, Cepollaro C. Effect of Simvastatin treatment on bone mineral density and bone turnover in hypercholesterolemic postmenopausal women: A 1-year longitudinal stu dy. 2003;32:427–33.
7.
Watanabe S, Fukumoto S, Takeuchi Y. Effects of 1-year treatment with Fluvastatin or Pravastatin on bone. Am J Med. 2001;110:584–7.
8.
Edwards CJ, Hart DJ, Spector TD. Oral statins and increased bone-mineral density in postmenopausal women. Lancet. 2000;355:2218–9.
9.
Chung YS, Lee MD, Lee SK. HMG-CoA redu ctase inhibitors increase BMD in type 2 diabetes mellitus patients. J Clin Endocrinol Metab. 2000;85:1137–42.
10.
Adami S, Braga V, Gatti D. Association between bone mineral density and serum lipids in men. JAMA. 2001;286:791–2.
11.
Kanis JA, Johnell O, Oden A. Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone. 2000;27:585–90.
12.
Rosa JC, J H, S V. Effect of statins on risk of coronary disease: A meta-analysis of rando mized controlled trials. JAMA. 1999;282:2340–6.
13.
Reid IR, Hague W, Emberson J. Effect of pravastatin on frequency of fracture in the LIPID study: Secondary analysis of a randomised contro lled trial. In: Long-term Intervention with Pravastatin in Ischaemic Disease Lancet 2001;357:509-12.
14.
Staa TP, S W, Vries F. Use of statins and risk of fractures. JAMA. 2001;285:1850–5.
15.
Pasco JA, Kotowicz MA, Henry MJ. Statin use, bone mineral density, and fracture risk: Geelong Osteoporosis Study. Arch Intern Med. 2002;162:537–40.
16.
Chan KA, Andrade SE, Boles M. Inhibitors of hydroxymethylglutaryl-coenzyme A reductase and risk of fracture among older women. Lancet. 2000;355:2185–8.
17.
Wang PS, Solomon DH, Mogun H. HMG-CoA reductase inhibitors and the risk of hip fractures in elderly patients. JAMA. 2000;283:3211–6.
18.
A. RIRT, CP C. Comparison of the effects of pravastatin and atorvastatin on fracture incidence in the PROVE IT-TIMI 22 trial-Secondary analysis of a randomized controlled trial. Bone. 2005;37(190):191.
19.
Mundy G, Garrett R, Harris S. Stimulation of bone formation in vitro and in rodents by statins. Science. 1999;286:1946–9.
20.
Beek E, C L, Pluijm G. The role of geranylgeranylation in bone resorption and its suppression by bisphosphonates in fetal bone ex plants in vitro: A clue to the mechanism of action of nitrogen-containing bisphosphonates. J Bone Miner Res. 1999;14:722–9.
21.
Heart Protection Study Collaborative Group: MRC /BHF Heart Protection Study of cholesterol lowering with Simvastatin in 20536 high risk individuals: A randomised placebo-controlled trial. Lancet. 2002;360:7–22.
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