Efficacy of statins for osteoporosis: a systematic review and meta-analysis

被引:113
作者
An, T. [1 ]
Hao, J. [2 ]
Sun, S. [1 ]
Li, R. [1 ]
Yang, M. [1 ]
Cheng, G. [3 ]
Zou, M. [3 ]
机构
[1] Shenyang Pharmaceut Univ, Dept Life Sci & Biopharmaceut, Shenyang 110016, Peoples R China
[2] Gen Hosp Shenyang Mil Command, Dept Blood Purificat, Shenyang 110016, Peoples R China
[3] Shenyang Pharmaceut Univ, Dept Pharm, Shenyang 110016, Peoples R China
关键词
Bone maker; Bone mineral density; Fracture; HMG-CoA reductase inhibitors; Osteoporosis; Statins; BONE-MINERAL DENSITY; COA REDUCTASE INHIBITORS; RANDOMIZED CONTROLLED-TRIAL; HYPERCHOLESTEROLEMIC POSTMENOPAUSAL WOMEN; TYPE-2; DIABETES-MELLITUS; FRACTURE RISK; HYDROXYMETHYLGLUTARYL-COENZYME; SIMVASTATIN TREATMENT; TURNOVER MARKERS; HIP FRACTURE;
D O I
10.1007/s00198-016-3844-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Our meta-analysis assessed the efficacy of statins on the risk of fracture, bone mineral density (BMD), and the markers of bone metabolism by collecting data from 33 clinical trials. We found that statin treatment was associated with bone metabolism. And statins seemed to be more effective on male patients with osteoporosis. The efficacy of statins for the treatment of osteoporosis has been controversial in previous studies and meta-analyses. Our meta-analysis was conducted to examine in detail the efficacy of statins on osteoporosis. We searched PubMed, Embase, and the Cochrane Library databases for clinical trials from inception to May 2016. We included studies that described the effect of statins on the risk of fracture, BMD, or bone turnover markers. Moreover, we also conducted subgroup analyses according to the skeleton site, patient gender, and length of follow-up. A total of 33 studies which included 23 observational studies (16 cohort studies and 7 case-control studies) and 10 randomized controlled trials (RCTs) were evaluated. These 33 studies included 314,473 patients in statin group and 1,349,192 patients in control group. Statins decreased the risk of overall fractures (OR = 0.81, 95% CI 0.73-0.89) and hip fractures (OR = 0.75, 95% CI 0.60-0.92). Furthermore, the use of statins was associated with increased BMD at the total hip (standardized mean difference (SMD) = 0.18, 95% CI 0.00-0.36) and lumbar spine (SMD = 0.20, 95% CI 0.07-0.32) and improved the bone formation marker, osteocalcin (OC) (SMD = 0.21, 95% CI 0.00-0.42). However, there was no positive effect on vertebral fractures, upper extremity fractures, BMD at the femoral neck, bone-specific alkaline phosphatase (BALP), and serum C-terminal peptide of type I collagen (S-CTX). Also, compared with male subgroups, the effect on female subgroups was only slightly positive or of no statistical significance. Our meta-analysis indicates that statin treatment may be associated with a decreased risk of overall fractures and hip fractures, an increased BMD at the total hip, BMD at the lumbar spine, and OC. Moreover, our results also show that statin treatment may have a greater effect on male patients than on female patients.
引用
收藏
页码:47 / 57
页数:11
相关论文
共 62 条
  • [1] Synergistic Effect of Statins and Postmenopausal Hormone Therapy in the Prevention of Skeletal Fractures in Elderly Women
    Bakhireva, Ludmila N.
    Shainline, Michael R.
    Carter, Shelley
    Robinson, Scott
    Beaton, Sarah J.
    Nawarskas, James J.
    Gunter, Margaret J.
    [J]. PHARMACOTHERAPY, 2010, 30 (09): : 879 - 887
  • [2] Use of statins and fracture - Results of 4 prospective studies and cumulative meta-analysis of observational studies and controlled trials
    Bauer, DC
    Mundy, GR
    Jamal, SA
    Black, DM
    Cauley, JA
    Ensrud, KE
    van der Klift, M
    Pols, HAP
    [J]. ARCHIVES OF INTERNAL MEDICINE, 2004, 164 (02) : 146 - 152
  • [3] Age-dependent effects of atorvastatin on biochemical bone turnover markers: a randomized controlled trial in postmenopausal women
    Berthold, HK
    Unverdorben, S
    Zittermann, A
    Degenhardt, R
    Baumeister, B
    Unverdorben, M
    Krone, W
    Vetter, H
    Gouni-Berthold, I
    [J]. OSTEOPOROSIS INTERNATIONAL, 2004, 15 (06) : 459 - 467
  • [4] CENTRELLA M, 1987, J BIOL CHEM, V262, P2869
  • [5] Inhibitors of hydroxymethylglutaryl-coenzyme A reductase and risk of fracture among older women
    Chan, KA
    Andrade, SE
    Boles, M
    Buist, DSM
    Chase, GA
    Donahue, JG
    Goodman, MJ
    Gurwitz, JH
    LaCroix, AZ
    Platt, R
    [J]. LANCET, 2000, 355 (9222) : 2185 - 2188
  • [6] Effects of atorvastatin on bone mineral density (BMD) and bone metabolism in elderly males with osteopenia and mild dyslipidemia: A 1-year randomized trial
    Chen Zhi-guo
    Cai Hua-jie
    Jin Xian
    Lu Jin-hua
    Wang Jing
    Fang Ning-yuan
    [J]. ARCHIVES OF GERONTOLOGY AND GERIATRICS, 2014, 59 (03) : 515 - 521
  • [7] Effects of statins vs. non-statin lipid-lowering therapy on bone formation and bone mineral density biomarkers in patients with hyperlipidemia
    Chuengsamarn, Somlak
    Rattanamongkoulgul, Suthee
    Suwanwalaikorn, Somponge
    Wattanasirichaigoon, Somkiat
    Kaufman, Larry
    [J]. BONE, 2010, 46 (04) : 1011 - 1015
  • [8] HMG-CoA reductase inhibitors increase BMD in type 2 diabetes mellitus patients
    Chung, YS
    Lee, MD
    Lee, SK
    Kim, HM
    Fitzpatrick, LA
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2000, 85 (03) : 1137 - 1142
  • [9] Dahiya N, 2014, MED J ARMED FORCES I, V71, P71
  • [10] Longitudinal study of periodontal disease and edentulism with rates of bone loss in older women
    Famili, P
    Cauley, J
    Suzuki, JB
    Weyant, R
    [J]. JOURNAL OF PERIODONTOLOGY, 2005, 76 (01) : 11 - 15