DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20151342

Statin therapy and Vitamin D

Arunkumar Radhakrishnan, A. Ruckmani, M. Abishek, S. Govindaraju

Abstract


Background: Statins are well-known drugs used in dyslipidemia and cardiac disorders since several years. Recently, it has been reported that long-term use of statins reduce serum vitamin D level. When statins are administered to patients with low vitamin D more muscular side effects have been reported. On the contrary, a few studies report that statins might increase vitamin D level competing with its metabolism. Hence, this study was conducted to evaluate the association between statins and vitamin D.

Methods: 125 participants who fulfilled the selection criteria were enrolled in the study. 65 subjects belonged to control group and 60, statin group. The blood sample was collected for Vitamin D estimation. The results were correlated with a demographic profile, nature of statin and the muscular side effects and compared with control group.

Results: The mean vitamin D level in statin group was 15.82 ng/ml±11.51 and 20.57 ng/ml±7.007 in the control group. The difference was found to be statistically significant.  13.85% in the control group and 10% in statin group had sufficient vitamin D level. 18.33% and 36.92 % had insufficient levels and 71.67% and 49.23% had a deficiency in the statin and control groups respectively.  Myalgia was reported by 30 among 60 subjects (50%) in statin group and 5 among 65 subjects (7.69%) in the control group.

Conclusion: The present study has shown that statin therapy is associated with low vitamin D level and that this could contribute to the increased incidence of myalgia in the statin group.


Keywords


Vitamin D, Statin, Atorvastatin, Myalgia, Dyslipidemia

Full Text:

PDF

References


Gresser U, Gathof BS. Atorvastatin: gold standard for prophylaxis of myocardial ischemia and stroke - comparison of the clinical benefit of statins on the basis of randomized controlled endpoint studies. Eur J Med Res. 2004;9(1):1 17.

Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366(9493):1267-78.

Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376(10):1670-81.

Cholesterol Treatment Trialists’ (CTT) Collaborators, Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012;380(9841):581-90.

Liao JK, Laufs U. Pleiotropic effects of statins. Annu Rev Pharmacol Toxicol. 2005;45:89-118.

Enas EA, Kuruvila A, Khanna P, Pitchumoni CS, Mohan V. Benefits and risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians - a population with the highest risk of premature coronary artery disease and diabetes. Indian J Med Res. 2013;138(4):461-91.

Schwartz JB. Effects of vitamin D supplementation in atorvastatin-treated patients: a new drug interaction with an unexpected consequence. Clin Pharmacol Ther. 2009;85(2):198-203.

Londhey V. Vitamin D deficiency: Indian scenario. J Assoc Physicians India. 2011;59:695-6.

Ritu G, Gupta A. Vitamin D deficiency in India: prevalence, causalities and interventions. Nutrients. 2014;6(2):729-75.

Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, et al. Vitamin D status in healthy Indians aged 50 years and above. J Assoc Physicians India. 2011;59:706 9.

Palamaner Subash Shantha G, Ramos J, Thomas-Hemak L, Pancholy SB. Association of vitamin D and incident statin induced myalgia – a retrospective cohort study. PLoS One. 2014;9(2):e88877.

Gupta A, Thompson PD. The relationship of vitamin D deficiency to statin myopathy. Atherosclerosis. 2011;215(1):23 9.

Kauffman JM. Benefits of vitamin D supplementation. J Am Physicians Surg. 2009;14(2):25-45.

Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999;69(5):842 56.

Lee RH, Weber T, Colón-Emeric C. Comparison of cost-effectiveness of vitamin D screening with that of universal supplementation in preventing falls in community-dwelling older adults. J Am Geriatr Soc. 2013;61(5):707-14.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30.