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| |  DG DISPATCH - ASBMR: Study Refutes Relationship Between Statins And Bone Mineral Density By Cameron Johnston Special to DG News
TORONTO, ON -- September 25, 2000 -- A new study has thrown cold water on the idea that there might be a correlation between a woman's use of drugs in the statin class, which includes some of the most popular cholesterol-busters today, and her bone mineral density. The study, dealing with one of the largest investigations into women’s health in the United States, if not in the world, was presented at the American Society of Bone and Mineral Research meeting, being held this week in Toronto, Canada. Earlier this year, three published studies claimed the opposite was true -- that women who used the cholesterol-lowering statins, atorvistatin, lovastatin, prevastatin and fluvastatin, had an increase in bone mineral density and, therefore, were at lower risk of fractures of the hip and lumbar spine. The Women's Health Initiative, an on-going study, examined records on fractures of the hip, wrist and lower arm among more than 7,800 women who used statins and 85,000 women who do not use statins. The results of this study show no correlation between them statin use and bone mineral density, researchers said. "The use of statins did not affect the risk of any type of fracture," said Andrea LaCroix, PhD, of the Fred Hutchinson Cancer Center, in Seattle, Washington, and co-principal investigator on the Women's Health Initiative, also based in Seattle. "The rates of fractures were similar among users and non-users of statins, regardless of how long or what type of statin medications had been taken," she added. There were 4.72 fractures of the wrist or lower arm per thousand women who reported using no statins at all, and the rate remained relatively unchanged at 4.69 per thousand among those who reported using statins for a period of greater than three years. Similarly, the incidence of hip fractures was 0.83 per thousand women among those who never used statins at all, and 1.13 per thousand among those who had used statins from one to three years. The earlier pro-statin studies were done on animals and claimed that, since bisphosphonates share many of the same pathways in the liver as the cells that produce cholesterol, there was a "cross-talk" between the cells and, therefore, statins would actually be beneficial at increasing bone mineral density. The studies actually looked at hundreds of compounds that shared the supposedly similar pathways, and found a tenuous link between bone mineral density and the use of one drug -- lovastatin -- in ovarectomized rats. This is a "murky and ambiguous area," said Dr. Robert Marcus, president-elect for the American Society of Bone and Mineral Research. The issue of what role, if any, statins play in bone mineral density was a hot topic at the Society's annual meeting. Just over six percent of the women who took part in the Women's Health Initiative were using statins at the time of enrollment (1993-97). Women who used statins tended to be older (65.9 years compared with 63.6 years) than non-statin users. Statin users were also less likely to be using hormone replacement therapy (42 per cent versus 46 per cent). There was no difference in total body and lumbar spine BMD between the two groups of women, while there was a slight unexplained difference in total hip BMD (adjusted for age and body mass index) in women who were using statins. If there is any correlation between hip BMD and statin use, it is "modest", Dr. LaCroix commented.
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