CHICAGO -- In a large study of elderly, predominately male veterans,statin use was associated with a 36 percent reduction in risk offracture when compared with no lipid-lowering therapy, according to astudy in the September 26 issue of Archives of Internal Medicine, oneof the JAMA/Archives journals.
Several biological mechanisms have been proposed to explain anassociation between statins and bone health, including reducedinflammation and promotion of new bone growth through improvements insmall blood vessel function, according to background information in thearticle. Previous studies have shown an association between statin useand fracture reduction. However, most studies have been of populationsof women even though many statin users are elderly men with heartdisease. The authors suggest that assessing this relationship in a malepopulation would be especially relevant.
Richard E. Scranton, M.D., M.P.H., of the Massachusetts VeteransEpidemiology Research and Information Center, Boston, and colleaguesanalyzed data from patients who received care in the V.A. health caresystem between January 1, 1998, and June 30, 2001 to compare the rateof bone fractures in individuals using statins versus those not takingstatins. Information on individuals' health status, race, age and bodymass index (BMI) as well as other medications that might be associatedwith bone fracture were included in the analysis. Of the 91,052individuals included in the study, 28,063 were prescribed only statins,2,195 were prescribed nonstatin lipid-lowering medications alone, andthe remaining 60,794 were not prescribed any lipid-lowering medicationsduring the period of the study.
"More than 28,000 of these individuals were using statins, making thisstudy one of the largest to evaluate the association between statinsand fractures," the researchers report. "The use of statins in thisstudy was associated with a 36 percent reduction in fracture riskcompared with no lipid-lowering therapy and a 32 percent risk reductionwhen compared with other lipid-lowering therapy. These findings did notdeviate significantly after adjustment for various covariates,including BMI."
"In our large cohort of mostly male veterans, statin therapywas associated with a reduction in fractures," the authors conclude.Our study represents one of the largest studies to date of individualsreceiving statins and the evaluation of fracture risk. Although we werelimited in adjusting for all known confounders, this study providesadditional information that fuels the debate of whether statins protectindividuals against fractures. Further research is necessary to confirmor refute our findings."
(Arch Intern Med. 2005; 165: 2007-2012. Available pre-embargo to media at www.jamamedia.org.)
Editor's Note: This study was supported by grants from the NationalInstitutes of Health, Bethesda, Md., the Arthritis Foundation, Atlanta,Ga., and the Department of Veterans Affairs, Washington, D.C.
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