Statins can be good or bad for your bone health, depending on the dosage

In a new study, researchers showed for the first time a connection between the dosage of cholesterol-lowering drugs—statins—and the diagnosis of osteoporosis.

They found at low doses, statins could protect against bone resorption. But the higher the dosage of cholesterol-lowering drugs, the greater the probability of osteoporosis.

The research was conducted by the Medical University of Vienna and the Complexity Science Hub Vienna.

Statins are among the most prescribed drugs worldwide. They lower high cholesterol and have been shown to reduce the risk of heart diseases.

Less well-researched are complications in connection with the intake of statins, such as a possible influence on pathological bone resorption (osteoporosis).

In the study, the team ran an analysis of millions of patient data by the Complexity Science Hub Vienna.

They had access to the health data of more than 7.9 million Austrians between 2006 and 2007.

They focused on those who regularly took statins for at least one year and also calculated the daily dosage of statins and formed different dosage groups.

The researchers found a correlation between the dosage of statins and the frequency of osteoporosis.

In the lower-dose groups, there were fewer osteoporosis cases than expected.

At doses up to 10 milligrams of the statins lovastatin, pravastatin, simvastatin or rosuvastatin, the scientists found fewer osteoporosis diagnoses compared to patients without statin therapy.

With doses of 20 milligrams and more, however, the tide seems to turn.

They found more osteoporosis cases in patients treated with simvastatin, atorvastatin, and rosuvastatin than expected. The higher the dosage, the stronger the effect.

The team explains that statins inhibit the synthesis of cholesterol from the liver. This lowers blood cholesterol. However, cholesterol is crucially important for many processes in the body.

Among other things, it is a basic building block for the production of sex hormones such as estradiol and testosterone.

Low concentrations of sex hormones—especially the drop in estrogen levels during menopause—are the main cause of the increase of osteoporosis in women.

There is a similar relationship between bone density and testosterone.

The team says the newly discovered correlation between statin therapy and osteoporosis risk should now be investigated in clinical studies.

The lead author of the study is Michael Leutner.

The study is published in the journal Annals of the Rheumatic Diseases.

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