title: Low plasma vitamin D levels and muscle-related adverse effects in statin users.
abstract: BACKGROUND
  Treatment with HMG-CoA reductase inhibitors (statins) is often complicated by muscle-related adverse effects (MAEs). Studies of the association between low plasma vitamin D levels and MAEs have yielded conflicting results.
  
  
  OBJECTIVE
  To determine if low plasma vitamin D level is a risk factorfor MAEs in statin users.
  
  
  METHODS
  Plasma levels of 25(OH) vitamin D were measured as part of the routine evaluation of unselected statin-treated patients attending the coronary and lipid clinics at our hospital during the period 2007-2010. Medical data on muscle complaints and statin use were retrieved from the medical files. Creatine kinase (CK) levels were derived from the hospital laboratory database.
  
  
  RESULTS
  The sample included 272 patients (141 men) aged 33-89 years. Mean vitamin D level was 48.04 nmol/L. Levels were higher in men (51.0 +/- 20.5 versus 44.7 +/- 18.9 nmol/L, P = 0.001) and were unaffected by age. MAEs were observed in 106 patients (39%): myalgia in 95 (35%) and CK elevation in 20 (7%); 9 patients (3%) had both. There was no difference in plasma vitamin D levels between patients with and without myalgia (46.3 +/- 17.7 versus 48.9 +/- 21.0 nmol/L, P = 0.31), with and without CK elevation (50.2 +/- 14.6 versus 47.8 +/- 20.3 nmol/L, P = 0.60), or with or without any MAE (50.4 +/- 15.0 versus 47.8 +/- 10.2 nmol/L, P = 0.27). These findings were consistent when analyzed by patient gender and presence/absence of coronary artery disease, and when using a lower vitamin D cutoff (< 25 nmol/L).
  
  
  CONCLUSIONS
  There is apparently no relationship between plasma vitamin D level and risk of MAEs in statin users.
authors.affiliation: Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Eisen
authors.affiliation: Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Lev
authors.affiliation: Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: Zaza
authors.initials: Z
authors.lastname: Iakobishvilli
authors.affiliation: Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: Avital
authors.initials: A
authors.lastname: Porter
authors.affiliation: Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Brosh
authors.affiliation: Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Hasdai
authors.affiliation: Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: Aviv
authors.initials: A
authors.lastname: Mager
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D063806:Myalgia / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D003402:Creatine Kinase