title: Statin myalgia is not associated with reduced muscle strength, mass or protein turnover in older male volunteers, but is allied with a slowing of time to peak power output, insulin resistance and differential muscle mRNA expression.
abstract: Statins are associated with muscle myalgia and myopathy, which probably reduce habitual physical activity. This is particularly relevant to older people who are less active, sarcopaenic and at increased risk of statin myalgia. We hypothesised that statin myalgia would be allied to impaired strength and work capacity in older people, and determined whether differences aligned with divergences in lean mass, protein turnover, insulin sensitivity and the molecular regulation of these processes. Knee extensor strength and work output during 30 maximal isokinetic contractions were assessed in healthy male volunteers, nine with no statin use (control 70.4 ± 0.7 years) and nine with statin myalgia (71.5 ± 0.9 years). Whole body and leg glucose disposal, muscle myofibrillar protein synthesis (MPS) and leg protein breakdown (LPB) were measured during fasting (≈5 mU l(-1) insulin) and fed (≈40 mU l(-1) insulin + hyperaminoacidaemia) euglyceamic clamps. Muscle biopsies were taken before and after each clamp. Lean mass, MPS, LPB and strength were not different but work output during the initial three isokinetic contractions was 19% lower (P < 0.05) in statin myalgic subjects due to a delay in time to reach peak power output. Statin myalgic subjects had reduced whole body (P = 0.05) and leg (P < 0.01) glucose disposal, greater abdominal adiposity (P < 0.05) and differential expression of 33 muscle mRNAs (5% false discovery rate (FDR)), six of which, linked to mitochondrial dysfunction and apoptosis, increased at 1% FDR. Statin myalgia was associated with impaired muscle function, increased abdominal adiposity, whole body and leg insulin resistance, and evidence of mitochondrial dysfunction and apoptosis.
authors.affiliation: MRC/Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, NG7 2UH, UK.
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mallinson
authors.forename: Kanagaraj
authors.initials: K
authors.lastname: Marimuthu
authors.forename: Andrew
authors.initials: A
authors.lastname: Murton
authors.forename: Anna
authors.initials: A
authors.lastname: Selby
authors.forename: Kenneth
authors.initials: K
authors.lastname: Smith
authors.forename: Dumitru
authors.initials: D
authors.lastname: Constantin-Teodosiu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rennie
authors.forename: Paul L
authors.initials: PL
authors.lastname: Greenhaff
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000009:adverse effects*; D000069059:Atorvastatin / Q000009:adverse effects; D016022:Case-Control Studies; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009119:Muscle Contraction; D009124:Muscle Proteins / Q000235:genetics / Q000378:metabolism*; D053580:Muscle Strength; D018908:Muscle Weakness / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism*; D011930:Reaction Time; D019821:Simvastatin / Q000009:adverse effects
chemical_list: D000924:Anticholesteremic Agents; D009124:Muscle Proteins; D012333:RNA, Messenger; D000069059:Atorvastatin; D019821:Simvastatin