title: Metabolic syndrome is associated with muscle symptoms among statin users.
abstract: Muscle symptoms have been associated with statin use, but the relationship of statin-associated muscle symptoms with metabolic syndrome (MS) has not been reported previously.
  
  
  
  To evaluate the relationships between MS and its individual components with statin-associated muscle symptoms.
  
  
  
  Data were analyzed from the Understanding Statin Use in America and Gaps in Education (USAGE) study. Modified criteria to define the MS were used based on self-reported survey data.
  
  
  
  Among USAGE subjects, the MS was present in 1364 of 3992 men (34.2%) and in 1716 women of 6149 women (27.9%). Subjects with the MS were 19% more likely (P = .0002) to report new or worsening muscle symptoms while on a statin. Three MS criteria-increased BMI, elevated triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C)-were associated with increased odds of muscle symptoms, by 18%, 32%, and 28%, respectively (all P < .001). The presence of MS also predicted increased odds of having discontinued a statin due to muscle symptoms (13% higher, P = .043). Among criteria for the MS, elevated TG (38% higher odds, P < .0001) and low HDL-C (37% higher odds, P = .0003) were positively associated with statin discontinuation, whereas hypertension (13% lower odds, P = .019) and diabetes mellitus (12% lower odds, P = .036) were inversely associated.
  
  
  
  USAGE participants with MS were more likely to report experiencing muscle symptoms while taking a statin and to have discontinued a statin due to muscle symptoms. This appears to be attributable mainly to associations of muscle symptoms with elevated TG and low HDL-C levels. Additional research is warranted to confirm and further investigate these associations.
authors: Utah Lipid Center and the Division of Atherometabolic Research, Utah Foundation for Biomedical Research, Salt Lake City, UT, USA. Electronic address: eliot.brinton@utah.edu.
authors: Eliot A
authors: EA
authors: Brinton
authors: Midwest Center for Metabolic & Cardiovascular Research/MB Clinical Research, Glen Ellyn, IL, USA.
authors: Kevin C
authors: KC
authors: Maki
authors: Emory University, Atlanta, GA, USA.
authors: Terry A
authors: TA
authors: Jacobson
authors: Kowa Pharmaceuticals America, Inc., Montgomery, AL, USA.
authors: Craig A
authors: CA
authors: Sponseller
authors: St Louis University, St Louis, MO, USA.
authors: Jerome D
authors: JD
authors: Cohen
mesh_terms: D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009132:Muscles / Q000187:drug effects*; D010146:Pain / Q000150:complications; D028761:Withholding Treatment
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: HMG CoA reductase inhibitors (statins); Insulin resistance; Metabolic syndrome; Muscle pain; Muscle weakness; Statin intolerance