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Statin use and longitudinal changes in quantitative MRI-based biomarkers of thigh muscle quality: data from Osteoarthritis Initiative

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Abstract

Objective

To assess whether changes in MRI-based measures of thigh muscle quality associated with statin use in participants with and without/at-risk of knee osteoarthritis.

Methods

This retrospective cohort study used data from the Osteoarthritis Initiative study. Statin users and non-users were matched for relevant covariates using 1:1 propensity-score matching. Participants were further stratified according to baseline radiographic knee osteoarthritis status. We used a validated deep-learning method for thigh muscle MRI segmentation and calculation of muscle quality biomarkers at baseline, 2nd, and 4th visits. Mean difference and 95% confidence intervals (CI) in longitudinal 4-year measurements of muscle quality biomarkers, including cross-sectional area, intramuscular adipose tissue, contractile percent, and knee extensors and flexors maximum and specific contractile force (force/muscle area) were the outcomes of interest.

Results

After matching, 3772 thighs of 1910 participants were included (1886 thighs of statin-users: 1886 of non-users; age: 62 ± 9 years (average ± standard deviation), range: 45–79; female/male: 1). During 4 years, statin use was associated with a slight decrease in muscle quality, indicated by decreased knee extension maximum (mean-difference, 95% CI: − 1.85 N/year, − 3.23 to − 0.47) and specific contractile force (− 0.04 N/cm2/year, − 0.07 to − 0.01), decreased thigh muscle contractile percent (− 0.03%/year, − 0.06 to − 0.01), and increased thigh intramuscular adipose tissue (3.06 mm2/year, 0.53 to 5.59). Stratified analyses showed decreased muscle quality only in participants without/at-risk of knee osteoarthritis but not those with established knee osteoarthritis.

Conclusions

Statin use is associated with a slight decrease in MRI-based measures of thigh muscle quality over 4 years. However, considering statins’ substantial cardiovascular benefits, these slight muscle changes may be relatively less important in overall patient care.

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Data availability

The de-identified clinical and demographic information of subjects is publicly available at the osteoarthritis initiative project data repository at https://oai.nih.gov.

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Acknowledgements

The Osteoarthritis Initiative, a collaborative project between public and private sectors, includes five contracts N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. This project is conducted by the Osteoarthritis Initiative project investigators and is financially supported by the National Institutes of Health (NIH). Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer, Inc. were the private funding partners.

In preparing this manuscript, osteoarthritis initiative project publicly available datasets were used. The results of this work do not necessarily reflect the opinions of the osteoarthritis initiative project investigators, the NIH, or the private funding partners.

Funding

This research was supported by the NIH National Institute of Aging (NIA) under Award Number P01AG066603 and NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) under Award Number R01AR079620-01.

Author information

Authors and Affiliations

  1. Russell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD, 21287, USA

    Bahram Mohajer, Hamza A. Ibad & Shadpour Demehri

  2. Russell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, USA, Baltimore

    Kamyar Moradi & Mahsa Dolatshahi

  3. Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, MA, USA

    Ali Guermazi & Frank W. Roemer

  4. Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany

    Frank W. Roemer

  5. University of Maryland Baltimore, Baltimore, MD, USA

    Ghazaal Parastooei

  6. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds, UK

    Philip G. Conaghan

  7. Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Bashir A. Zikria, Mei Wan & Xu Cao

  8. Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Joao A. C. Lima

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  1. Bahram Mohajer
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Corresponding author

Correspondence to Bahram Mohajer.

Ethics declarations

Ethics approval

The medical ethics review boards of the University of California, San Francisco (Approval Number: 10–00532) and the four clinical centers of Osteoarthritis Initiative project recognized the project as Health Insurance Portability and Accountability Act (HIPAA)-compliant. This project was in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments, and all individuals gave their informed consent prior to their inclusion in the study. The authors of this manuscript certify that they comply with the ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia, and Muscle.

Patient consent

Subjects have given informed consent before participating in the Osteoarthritis Initiative (OAI) project.

Conflict of interest

None of the authors has any conflicting personal or financial relationships with the organization that sponsored the research (NIH) that could have influenced the results of this study. FWR is chief marketing officer and shareholder of Boston Imaging Core Lab (BICL), LLC, and consultant to Calibr — California Institute of Biomedical Research and Grünenthal GmbH. AG is a shareholder of BICL and consultant to Pfizer, TissueGene, MerckSerono, Novartis, Regeneron, and AstraZeneca. SD reported that he received funding from Toshiba Medical Systems (for consultation) and grants from GERRAF and Carestream Health (for a clinical trial study). PGC is supported in part through the UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the Department of Health. Other authors declare that they did not have any competing interests.

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Mohajer, B., Moradi, K., Guermazi, A. et al. Statin use and longitudinal changes in quantitative MRI-based biomarkers of thigh muscle quality: data from Osteoarthritis Initiative. Skeletal Radiol 53, 683–695 (2024). https://doi.org/10.1007/s00256-023-04473-7

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