title: Influence of vitamin D status on the effect of statins on bone mineral density and bone turnover markers in postmenopausal women.
abstract: OBJECTIVE
  This study sought to assess whether the association between statin use and bone mineral density (BMD) and bone turnover markers is modulated by serum 25-hydroxyvitamin D (25OHD) levels in postmenopausal women. Design, Participants, and Settings: Approximately 1422 postmenopausal women were recruited from the Camargo Cohort after excluding those with any known medical disorder or drug that might affect bone metabolism. Participants were categorized into four groups: 25OHD levels of 20 ng/mL or less and not taking statins (group 1; n = 492); 25OHD levels greater than 20 ng/mL and on statins (group 2; n = 143); 25OHD levels of 20 ng/mL or less and using statins (group 3; n = 112); and 2OHD levels greater than 20 ng/mL and non-statin use (group 4; n = 675). Multivariate analyses were performed to compare BMD and bone turnover markers between groups.
  
  
  RESULTS
  Women in group 2 had an adjusted femoral neck and total hip BMD higher than women in group 1 (P < .0001 and P = .003, respectively). A trend toward a significant difference was observed regarding lumbar BMD (P = .08). Serum aminoterminal propeptide of type 1 collagen and C-terminal telopeptide of type 1 collagen levels were lower in group 2 than in group 1, in crude and adjusted models, although only serum C-terminal telopeptide of type 1 collagen difference was significant (P = .009).
  
  
  CONCLUSIONS
  Women on statins and serum 25OHD levels above 20 ng/mL have greater BMD and less bone resorption than those without either of the factors. Differences, however, are not significant in women with only one of them. Vitamin D and statins seem to interact positively in their effects on bone metabolism.
authors.affiliation: Bone Metabolic Unit (J.L.H., J.M.O., J.M., S.R., J.G.-M.), Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla, University of Cantabria, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad, and Epidemiology Unit (J.L.), Medical School, University of Cantabria, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, 39008 Santander, Spain; and Centro de Salud Camargo (G.R., J.C., J.d.J., I.P.-P.), 39600 Santander, Spain.
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: Javier
authors.initials: J
authors.lastname: Llorca
authors.forename: Josefina
authors.initials: J
authors.lastname: Martínez
authors.forename: Jesús
authors.initials: J
authors.lastname: Castillo
authors.forename: Julia
authors.initials: J
authors.lastname: de Juan
authors.forename: Isabel
authors.initials: I
authors.lastname: Pérez-Pajares
authors.forename: Sheila
authors.initials: S
authors.lastname: Ruiz
authors.forename: Jesús
authors.initials: J
authors.lastname: González-Macías
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D016723:Bone Remodeling / Q000187:drug effects* / Q000502:physiology; D024042:Collagen Type I / Q000097:blood; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000378:metabolism; D017698:Postmenopause / Q000187:drug effects* / Q000378:metabolism; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014807:Vitamin D; C104450:25-hydroxyvitamin D