Statins, fracture risk, and bone remodeling: What is true?
Besides the action on plasma lipid levels, statins show a series of ancillary effects defined as all of their vascular and nonvascular effects independent from the cholesterol reduction. It has been recently hypothesized that one of these ancillary effects could be the improvement of bone health, due to the interference with bone metabolism. This may potentially represent the rationale for statins' use in the treatment of osteoporosis, the most common disease of the bone. Both experimental observations and clinical studies on this topic generated a number of conflicting results; however, the largest randomized clinical trials, the Scandinavian Simvastatin Survival Study (4S), Long Term Intervention with Pravastatin in Ischemic Disease (LIPID), and Heart Protection Study (HPS), indicate that statins do not prevent or reduce fracture risk.
Rizzo
Manfredi
M
Department of Clinical Medicine and Emerging Diseases, University of Palermo, Palermo, Italy.. Electronic address: mrizzo@unipa.it.
Rini
Giovam Battista
GB
Department of Clinical Medicine and Emerging Diseases, University of Palermo, Palermo, Italy.
D016723:Bone Remodeling / Q000187:drug effects*; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D017202:Myocardial Ischemia / Q000517:prevention & control; D010024:Osteoporosis / Q000188:drug therapy*; D017035:Pravastatin / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D019821:Simvastatin / Q000627:therapeutic use*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin; D017035:Pravastatin