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Statin but not Non-Statin Lipid-Lowering Drugs Decrease Fracture Risk: A Nation-Wide Case-Control Study

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Abstract

Introduction

Discrepant results have been reported on association between treatment with lipid lowering drugs and fracture risk. Several studies have failed to demonstrate an effect of statins on bone mineral density. Therefore, the epidemiological findings of a reduced fracture risk may be due to selections bias, e.g. a healthy drug user effect. If so, the reduced fracture risk is most likely independent of type of lipid lowering drug.

Aim

We assessed fracture risk in users of various lipid-lowering drugs.

Methods

In a case-control design, we compared 124,655 fracture cases with 373,962 age- and gender-matched controls. We used computerized registers to assess individual drug use and related these data to individual fracture data and information on potential confounders.

Results

Use of statins was associated with a reduced risk of any fracture (adj. OR 0.87; 95% CI, 0.83–0.92) and hip fractures (adj. OR 0.57; 95% CI, 0.48–0.69). Risk of hip fracture decreased with increased accumulated dose of statins. This was true in men and in women and in subjects younger and older than 65 years of age. However, fracture risk was not reduced in patients treated with pravastatin (adj. OR 1.02; 95% CI, 0.89–1.17) or non-statin lipid lowering drugs (adj. OR 0.99; 95% CI, 0.86–1.15).

Conclusions

The reduced fracture risk in users of lipid lowering drugs is apparently specifically related to users of non-pravastatin statins. Our findings do not support the hypothesis of a healthy drug user effect as an explanation for the reduced fracture risk in users of statins.

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Acknowledgments

The Danish Medical Research Council provided financial support. The National Bureau of Statistics, Denmark is acknowledged for its help in providing data.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus Sygehus, Tage Hansens Gade 2, Aarhus C, DK-8000, Denmark

    L. Rejnmark, P. Vestergaard & L. Mosekilde

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  1. L. Rejnmark
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  2. P. Vestergaard
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  3. L. Mosekilde
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Correspondence to L. Rejnmark.

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Rejnmark, L., Vestergaard, P. & Mosekilde, L. Statin but not Non-Statin Lipid-Lowering Drugs Decrease Fracture Risk: A Nation-Wide Case-Control Study. Calcif Tissue Int 79, 27–36 (2006). https://doi.org/10.1007/s00223-006-0024-4

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  • DOI: https://doi.org/10.1007/s00223-006-0024-4

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