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Low vitamin D level potential risk factor for statin-related myopathy
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NASHVILLE, Tenn. - Low vitamin D level is a potentially significant risk factor for statin-related myopathy, particularly for black patients, according to study findings presented here.
In an analysis comparing characteristics between veterans with and without statin-related myopathy, vitamin D levels were similar, but tended to be lower in the group with statin-related myopathy, according to researchers. Statin-related myopathy is defined as muscle pain or weakness with a normal creatine kinase level (myalgia), elevated creatine kinase level (myositis) or a 10-fold increase in creatine kinase levels (rhabdomyolysis).
“Our study did not show significant difference in vitamin D levels between the groups; however, all patients had low vitamin D, and there was a trend toward even lower levels in the group with [statin-related myopathy],” the researchers wrote.
Sandra Aleksic, MD, of Rutgers New Jersey Medical School, and colleagues analyzed data from 281 patient consultations for vitamin D repletion at the VA New Jersey Health Care System, East Orange Campus, completed between January and March 2013.
Sandra Aleksic
Within the cohort, 123 patients were assigned statins, and 18 of those patients (89% men) had a history of statin-related myopathy. Researchers performed t tests and z tests to determine the significance of the difference between groups.
In the group with statin-related myopathy, 10 patients had myalgia, five had myositis, one had rhabdomyolysis and two had statin-related myopathy with no documented creatine kinase levels. Most myopathies were related to simvastatin use (72%), followed by atorvastatin (17%), lovastatin (11%) and pravastatin (6%).
The group with statin-related myopathy was younger (62.7 vs. 69.6 years; P = .039), had more patients assigned medications altering statin metabolism, such as warfarin, digoxin or niacin (P = .004), and had a higher proportion of black patients (P = .012) than the group without statin-related myopathy, according to researchers. There was no significant difference in vitamin D levels, BMI, the presence of liver or kidney disease, diabetes or calcium levels between the two groups.
“While a previous trial in veterans taking high-dose simvastatin showed association of [statin-related myopathy] and younger age as well, we also showed that African American veterans are at a potentially higher risk for [statin-related myopathy] in the setting of a low vitamin D level,” the researchers wrote. “Low vitamin D level is a potentially significant and correctable risk factor for statin-related myopathy in veterans.” - by Regina Schaffer
Reference :
Aleksic S, et al. Abstract 404. Presented at: AACE 24th Annual Scientific & Clinical Congress; May 13-17, 2015; Nashville, Tenn.
Disclosure: The researchers report no relevant financial disclosures.