Short-term effects of pitavastatin on biochemical markers of bone turnover in patients with hypercholesterolemia.
OBJECTIVE
No consensus has been reached whether clinical use of statins has beneficial effects on bone health, partly due to lower statin concentrations because of first-pass metabolism by the liver. We thus evaluated the effects of pitavastatin, which does not undergo first-pass metabolism, on bone metabolism.


METHODS
According to the therapeutic regimen, the subjects were divided into two groups (group A, 66 with pitavastatin; group B, 35 without pitavastatin). Bone-specific alkaline phosphatase (BAP) and serum N-terminal telopeptide of type I collagen (NTx) as bone turnover markers (BTMs) were compared between the two groups and between at baseline and after 3 months of treatment in each group. Correlations between baseline characteristics and deltaBTMs, and between delta lipid profile and deltaBTMs were investigated using both Pearson's correlation analysis and multivariate analysis.


METHODS
The subjects were 101 patients with untreated hypercholesterolemia.


RESULTS
After 3 months of treatment, BAP in group A did not change significantly compared with either the baseline value or that in group B. However, NTx in group A significantly decreased compared with both the baseline value and that in group B. In addition, deltaNTx was negatively correlated with NTx at baseline, and the significance of this correlation persisted after multiple regression analysis.


CONCLUSIONS
Our findings suggest that pitavastatin may have potentially beneficial effects on bone metabolism primarily by reducing bone resorption rather than by stimulating bone formation. Further studies with more patients and longer duration are warranted to evaluate its effects, if any, on prevention of osteoporosis and subsequent fractures.
Majima
Takafumi
T
Division of Metabolic Research, Clinical Research Institute, Center for Endocrine and Metabolic Diseases, National Hospital Organization, Kyoto Medical Center. spdf3ea9@room.ocn.ne.jp
Shimatsu
Akira
A
Komatsu
Yasato
Y
Satoh
Noriko
N
Fukao
Atsushi
A
Ninomiya
Kiyoshi
K
Matsumura
Tadashi
T
Nakao
Kazuwa
K
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001862:Bone Resorption / Q000188:drug therapy; D001842:Bone and Bones / Q000378:metabolism*; D024042:Collagen Type I / Q000097:blood*; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010012:Osteogenesis / Q000187:drug effects; D010024:Osteoporosis / Q000517:prevention & control; D010455:Peptides / Q000097:blood*; D011446:Prospective Studies; D011804:Quinolines / Q000494:pharmacology / Q000627:therapeutic use*; D013997:Time Factors
D015415:Biomarkers; D024042:Collagen Type I; D004791:Enzyme Inhibitors; D010455:Peptides; D011804:Quinolines; C052929:collagen type I trimeric cross-linked peptide; D000469:Alkaline Phosphatase; C108475:pitavastatin