Bone density with simvastatin and in physicians
Effects of simvastatin on bone turnover and bone mineral density (BMD). The statins are used extensively to treat high cholesterol levels and some researchers have noted increased BMD in people taking statins apparently through both bone stimulation and antiresorption. But, as we know, controlled clinical trials are required to verify whether there is an actual causal relationship between increased BMD and statins--that's what this study is about. See J Bone Miner Res. 2004 May;19(5):737-44, Rejnmark L and others. PMID: 15068496. This study was double-blinded and involved 82 healthy postmenopausal women who took either 40-mg simvastatin or placebo for one year, then were followed for six months after treatment stopped. As expected, there was a large (27%) reduction in plasma cholesterol in the treatment group compared to placebo. But, there were no changes in BMD of the lumbar spine, total hip, femoral neck or whole body at week 52 or 78 when compared to placebo. The authors conclude: "Our results do not support a general beneficial effect of simvastatin on bone." Editor's comment: There will be more studies in this area, so stay tuned. For now, it appears that the statins most likely have no great beneficial affect on bone density.
Do what I say, not what I do. See J Natl Med Assoc 2004 Mar;96(3):299-305, Reyes MO and others. PMID: 15040511. This was an observational cross-sectional study to determine bone mass in physicians and to see if calcium intake or exercise were related to bone mass. DXA was used to measure BMD in 100 physicians and they filled out a questionnaire to determine daily calcium intake and exercise. The results showed that in the population of 52% men and 48% women, mean age 42, low BMD occurred in 68% of the physicians. Interestingly, 17% had osteoporosis and 49% had osteopenia. A large percentage of the study group had low calcium intake and lacked adequate daily exercise. There was, however, no statistically significant relationship between calcium intake or exercise level and reduced BMD. Editor's comments: Although the reduced BMD is a significant finding that is disturbing, perhaps the most disturbing finding is that this group, which should be setting the example, was not taking adequate calcium nor getting enough exercise. I don't know about you, but it bothers me if I have a medical appointment and am getting advice from a physician who obviously isn't fit or healthy. These people surely have excuses for not setting a proper example, as we all do, but they should forget the excuses and get healthy.