The Effect of Statins on Serum Vitamin D Concentrations Among Older Adults

Abstract

Background Randomized and observational studies have previously reported inconsistent results for the direct association between statin therapy and 25, hydroxyvitamin D [25(OH)D] levels. Thus, the present study aimed to examine the relationship between statin use and 25(OH)D and its metabolites concentrations in a large nationally representative sample of older adults. Methods This study was conducted using data from the National Health and Nutrition Examination Survey. Participants were asked to show the medication containers of all the products used in the previous 30 days, and the prescription of statins was defined on the three-level nested therapeutic classification scheme of Cerner Multum's Lexicon. General linear models adjusted for potential confounders were created to compare 25(OH)D concentrations between older adults taking statins and those who did not. Results A total of 6,261 participants with a mean age of 69.5 years comprised the study sample. Of those, 40.2% were taking statins with a median length of therapy of 5 years. Adjusted mean 25(OH)D 3 and 25(OH)D levels were 3.3 and 4.4 nmol/L higher among participants taking statins than those who did not, respectively. Moreover, this association was consistently seen regardless of the duration of therapy and particularly in subjects taking simvastatin, atorvastatin, or rosuvastatin. In subgroup analyses according to BMI categories and vitamin D intake, higher 25(OH)D levels were also seen among statin users. By contrast, this association was attenuated among those with a daily vitamin D between 400 and 800 and >800 IU. Conclusion Older adults on statin therapy had significantly higher serum 25(OH)D concentrations. Additional research should be conducted to define the mechanism of this association and determine if the pleiotropic effects attributed to statins may be mediated by vitamin D.

Genetically instrumented LDL‐cholesterol lowering and multiple disease outcomes: A Mendelian randomization phenome‐wide association study in the UK Biobank

“…It is commonly suggested that 25(OH)D deficiency is linked with increased risk of hyperlipidaemia and cardiovascular disease 49,50 ; however, a recent study in the National Health and Nutrition Examination Survey database found that statin users had significantly higher 25(OH)D levels compared to non-users. 51 We found an association between the statin proxy and lower levels of vitamin D, alkaline phosphatase and calcium, while PCSK9 and LDLR CYP51A1 and interrupt cholesterol biotransformation. 52 It is also possible that HMGCR inhibition inhibits 7-dehydrocholesterol synthesis, which acts as a precursor to both cholesterol and vitamin D. 53 In line with earlier studies by Ference et al 54 and Lotta et al, 55 the HMGCR and NPC1L1 genetic instruments were associated with HbA1c (glycated haemoglobin), an indicator of increased diabetes risk.…”

Effect of atorvastatin on bone formation in ovariectomized rats

“…However, in a study on patients with hyperlipidemia, they were given 10mg of rosuvastatin led to a significant increase in 25(OH)D levels (33). The exact mechanism of statins effect on 25(OH)D metabolism is not understood, but some researchers have proposed that 7dehydrocholesterol is the precursor of vitamin D and cholesterol, and the inhibition of 3-hydroxy-3methylglutaryl coenzyme A reductase leads to an elevation in 7dehydrocholesterol levels, this may offer a substrate for 25hydroxy vitamin D synthesis (34).…”

Low dose hydrophilic statins are the preferred agents for females at risk of osteoporosis

“…There is no official recommendation for using statin therapy in patients with osteoporosis as the data is very heterogeneous regarding dose-effect correlation, statin effect on sex hormones levels (estradiol and testosterone), and vitamin D levels ( Leutner et al, 2019 ; Thabit et al, 2014 ; Hsia et al, 2002 ; Varri et al, 2016 ; Orces et al, 2020 ).…”