We studied 2,315 subjects (1,422 women and 893 men) from the Camargo Cohort and analyzed the differences in BMD between statin or non-statin users. We also studied effects of the type of statin, dose, pharmacokinetic properties, and length of treatment on bone mineral density (BMD). Of the subjects, 478 (21 %) were taking statins (256 women and 222 men). Overall, they had higher BMD than non-users (p < 0.0001). In adjusted multivariate models, women taking statins had higher BMD at femoral neck (p = 0.002) and total hip (p = 0.04) than non- users. No differences were found in men. Women taking simvastatin had higher increases in BMD than non-statin users at femoral neck (p = 0.02) and total hip (p = 0.009), those taking fluvastatin had lower BMD values at lumbar spine (p = 0.028), and those receiving lovastatin had higher increases at femoral neck (p = 0.006). In men, only atorvastatin was associated with higher femoral neck BMD than non-statin use (p = 0.029). Comparing with non-statin users, only women receiving lipophilic statins had greater BMD at femoral neck (p = 0.003). According to drug potency, women on high- or lower-potency agents showed higher BMD values at femoral neck than non-users (p = 0.028 and 0.022, respectively). In men, only high-potency statins were associated with higher femoral neck BMD than non-use (p = 0.021). No differences between dose or length of statin therapy were noted regarding BMD in either sex. In summary, in a large population-based cohort, women on statins had higher BMD at the hip than non-users. Overall, this increase in BMD was more evident in subjects on lipophilic or high-potency statins.
Women on statins and serum 25OHD levels above 20 ng/mL have greater BMD and less bone resorption than those without either of the factors. Differences, however, are not significant in women with only one of them. Vitamin D and statins seem to interact positively in their effects on bone metabolism.
SummaryThe quantity and quality of protein in the diet affect both nitrogen balance and energy utilization in man. One possible mechanism is by a direct effect on the process of fat digestion and absorption. The effect on fat absorption of feeding diets providing 0%, 6.49'0, or 12.5% of energy as protein was assessed in nine children. Liquid diets were prepared by high speed blending of calcium caseinate, a soy-cottonseed oil blend (80:20), sucrose, water, vitamins, and a mineral mixture and fed by bottle five times per day. Diets varied in the amount of protein and were fed to maintain constant the intakes of fat and carbohydrate. All children began by consuming the diet providing 6.4% of energy a s protein for a period of 6 days: 3 days of adaptation, 3 days of metabolic collection of urine and stool. Successive 3-day dietary periods and metabolic collections followed in one of two sequences: 12.570, 0%, 6.4% energy as protein in five children; 0%, 12.5%, 6.4% energy as protein in four. Mean fat excretion during the two 6.4% periods did not differ significantly (initial 14.5 * 6 % of intake; final, 11.7 * 5.0% of intake). Fat excretion was significantly greater during the period when no protein was consumed (23.9 + 7.7% of intake) than during either the period in which protein provided 6.4% of energy ( P < 0.01) or during that in which protein provided 12.5% of energy (10.0 + 2.6% of intake, P < 0.001).The difference between the 6.4% and 12.5% periods did not attain significance ( P = 0.10). Fecal fat expressed as a percentage of fecal dry weight was significantly greater during periods when the diet contained no protein than during periods in which protein provided either 6.4% ( P C 0.05) or 12.5% ( P < 0.01) of energy.Additional studies were carried out in a similar fashion in six children consuming diets in which protein provided 5%, 9.6%, and 15% of energy. All six possible dietary sequences were used. At these intakes fat excretion did not vary significantly with . protein intake. SpeculationThe low protein intake of children in much of the developing world may be detrimental to maximal fat absorption and consequently may increase their energy requirements.The quantity and quality of protein in the diet affect both nitrogen balance and energy utilization in man. Consumption of inadequate amounts of protein may result in decreased nitrogen retention and poor weight gain despite sufficient energy intake (5). Under such conditions, energy output may be regulated by increasing the amount of energy dissipated from the organism as heat (10). A second possible mechanism by which protein intake may affect energy balance is by a direct effect on the process of fat digestion and/or absorption.In studies designed to assess the effect on nitrogen retention of consuming a diet in which all of the day's protein was fed to children in a single meal, with energy distributed evenly in five feedings throughout the day, we noted a marked increase in fecal fat excretion relative to control periods of even proteinlenergy dist...
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