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Statin Use Cut Risk of Osteoporosis and Fractures

A recent study found that statin use reduced the risks of osteoporosis, hip fracture, and vertebral fracture in stroke patients by 30% to 40%, and a dose-effect relationship was observed between statin cumulative defined daily dose (cDDD) and decreased risks of osteoporosis and fractures.

The researchers said that other studies have identified osteoporosis and bone fracture risk factors and prevention strategies in stroke survivors. But the role of statin treatment in preventing osteoporosis and fracture has not been previously reported, and they said their study could have public health implications because of the high incidence and prevalence of stroke, osteoporosis, and bone fractures.
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Stroke is a major risk factor for osteoporosis and fractures because of a substantial loss of bone mineral density, gait disability, balance impairment, immobilization, and increase in fall risk after the stroke, the authors wrote. Fractures, which are a common complication of stroke, can further reduce functional recovery, prolong disability, and increase mortality risk.

Poststroke osteoporosis and consequent fractures increase the risk of morbidity and mortality and cause considerable socioeconomic burden.

Researchers used Taiwan’s National Health Insurance Research Database and identified patients newly diagnosed with a stroke between 2000 and 2012. After propensity score matching, 5254 patients were included, with 2627 patients in the statin and nonstatin cohorts, respectively.

Poststroke statin use was associated with a lower overall risk (adjusted hazard ratio [aHR], 0.66; P <.001).

In subanalyses, statin use was associated with a decreased risk of all individual outcomes, including osteoporosis (aHR, 0.68; P <.001), hip fracture (aHR, 0.59; P <.001), and vertebral fracture (aHR, 0.73; P = .003).

A dose-effect relationship was identified. The aHRs for developing the primary outcome were 0.96, 0.86, and 0.34 for patients who used 1 to 90, 91 to 365, and more than 365 cDDD of statins, respectively. These relationships were maintained on subgroup analyses stratified by age, sex, and stroke type and sensitivity analyses conducted without propensity score matching.

Many people will not know they have osteoporosis, a skeletal disorder characterized by loss of bone mass, deterioration of bone tissue, and decline in bone quality, until they have a fracture. In some cases, fractures can lead to disability, chronic pain, loss of independence, lower quality of life, and even death. About 21% to 30% of patients who experience a hip fracture die within 1 year.

By 2020, approximately 12.3 million individuals in the United States older than 50 years are expected to have osteoporosis.

Exactly how statins work in relation to osteoporosis and fracture risks is not yet fully understood, the researchers wrote.

Reference

Lin SM, Wang JH, Liang CC, Huang HK. Statin use is associated with decreased osteoporosis and fracture risks in stroke patients. J Clin Endocrinol Metab. 2018;103(9):3439-3448. doi: 10.1210/jc.2018-00652.

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