HEALTH NEWS

Study Title:

Low Vitamin D Leads to More Muscle Injuries in Those Taking Statins

Study Abstract

From press release:

Vitamin D deficiency appears to be prevalent among patients with hyperlipidaemia, but it occurs more frequently in patients with statin-associated myalgias, according to findings presented here at the American Heart Association (AHA) Scientific Sessions.

Myalgia occurs frequently among patients taking statins, but it is sometimes uncertain whether it is drug-related. Vitamin D deficiency is common in the general population and is sometimes associated with reversible myalgia, according to Barton Duell, MD, Oregon Health & Science University, Portland, Oregon.

Dr. Duell and colleagues conducted a study to determine whether vitamin D deficiency may contribute to symptoms of myalgia in 99 patients referred for tertiary care with a diagnosis of hyperlipidaemia.

Patients were aged 58.7 years on average (range 20-84) and 43% were men. The mean serum 25-hydroxyvitamin D level was 26.7 ng/mL (range 5-64).

Statin-associated myalgias were reported by 38.8% of patients. These patients had a 32% lower mean vitamin D level (20.5 vs 30.1 ng/mL, P = .0003) and were more likely to be female (68% vs 49%, P = .095).

Vitamin D levels were similar in men and women (24.3 vs 28.8 ng/mL, P = .09). Deficiency was prevalent in the group (62.6% <30 ng/mL; 31.9% <20 ng/mL).

Patients with myalgias were more likely to have vitamin D levels <30 ng/mL (81.3% vs 52.5%, P < .01) and <20 ng/mL (62.5% vs 18.6%, P < .01).

Among patients with vitamin D <20 ng/mL, 62.1% had statin-associated myalgias compared with 17.6% of patients with levels >30 ng/mL (P < .01).

About one-third of patients with myalgia reported fewer statin-associated myalgias after 8 to 12 weeks of unblinded treatment with high-dose ergocalciferol, but most subjects also changed to a different statin, according to the researchers.

They concluded that while vitamin D deficiency is common in patients with hyperlipidaemia, statin-associated myalgias were more commonly related to vitamin D deficiency, with a mean vitamin D level 32% lower than the mean for the entire group.

They noted that vitamin D levels below 20 ng/mL were associated with 4-fold higher rates of myalgias than levels higher than 30 ng/mL, and reduced myalgias were anecdotally related to treatment with vitamin D in some of these patients.

According to Dr. Buell, vitamin D deficiency either leads to statin-induced myalgias or may cause drug-unrelated myalgias in a subset of patients taking statins. This matter requires additional studies, he said.

Study Information

Barton Duell et al.
Among patients with vitamin D <20 ng/mL, 62.1% had statin-associated myalgias compared with 17.6% of patients with levels >30 ng/mL (P < .01).
American Heart Association (AHA) Scientific Sessions. New Orleans. 2008.
2008 November
Oregon Health & Science University, Portland, Oregon.