title: Bone turnover markers in statin users: a population-based analysis from the Camargo Cohort Study.
abstract: OBJECTIVE
  To analyze the effects of statin use on bone turnover markers (BTM), in participants from a large population-based cohort.
  
  
  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.
authors.affiliation: Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, University of Cantabria-IFIMAV, RETICEF, Santander, Spain. hernandezjluis@gmail.com
authors.forename: José L
authors.initials: JL
authors.lastname: Hernández
authors.forename: José M
authors.initials: JM
authors.lastname: Olmos
authors.forename: Galo
authors.initials: G
authors.lastname: Romaña
authors.forename: Josefina
authors.initials: J
authors.lastname: Martinez
authors.forename: Jesús
authors.initials: J
authors.lastname: Castillo
authors.forename: Irina
authors.initials: I
authors.lastname: Yezerska
authors.forename: Carmen
authors.initials: C
authors.lastname: Ramos
authors.forename: Jesús
authors.initials: J
authors.lastname: González-Macías
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D016723:Bone Remodeling / Q000187:drug effects*; D015331:Cohort Studies; D024042:Collagen Type I / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide