Effects of Vitamin D Supplementation in Patients with Statin-Associated Muscle Symptoms and Low Vitamin D Levels
- 1 December 2022
- journal article
- research article
- Published by Mary Ann Liebert Inc in Metabolic Syndrome and Related Disorders
- Vol. 20 (10), 567-575
- https://doi.org/10.1089/met.2021.0127
Abstract
Background: Statin therapy is a cornerstone of cardiovascular disease treatment and prevention. Unfortunately, 7%–29% of statin-treated patients complain of muscular fatigue, cramps, and/or pain (statin-associated muscle symptoms [SAMS]). In recent years, the important role of vitamin D in muscle health maintenance has been highlighted. In addition, hypovitaminosis D is very prevalent, and might be a reversible risk factor for SAMS occurrence. Methods: In our controlled intervention study, patients suffering from both SAMS and hypovitaminosis D underwent vitamin D replacement for 6 months. SAMS intensity and its impact on the quality of life were evaluated with a questionnaire during follow-up. A subgroup of patients who were not at the low-density lipoprotein cholesterol (LDL-C) target attempted a statin rechallenge after 3 months. Control subjects, with SAMS only, were not treated. Results: Blood vitamin D levels reached 261% of baseline values. Pain intensity was reduced by 63%, and all life quality indicators improved. At follow-up, percentage variations in SAMS intensity and in vitamin D levels were inversely related (r = 0.57, P = 0.002). In a multiple regression analysis, this association was found to be independent. Among the rechallenge subgroup, 75% successfully tolerated high-intensity statins during the follow-up. The parameters of interest were unchanged in control subjects. Conclusions: In our findings, the amount of increase in vitamin D concentrations is directly related to SAMS improvement. Although randomized studies are needed, 25(OH)D levels can be measured, and eventually supplemented, in all patients suffering from SAMS, and this can be done together with a statin rechallenge after 3 months for patients who are not at the LDL-C target. Register: The study protocol was registered with the EudraCT clinical trial register [ID: 2019-003250-83] in date April 8, 2020.Keywords
This publication has 40 references indexed in Scilit:
- Effect of Statins on Skeletal Muscle FunctionJournal of the American College of Cardiology, 2013
- Myopathy during statin therapy in the daily practice of an outpatient cardiology clinic: prevalence, predictors and relation with vitamin DCurrent Medical Research and Opinion, 2012
- Vitamin D deficiency, myositis–myalgia, and reversible statin intoleranceCurrent Medical Research and Opinion, 2011
- The relationship of vitamin D deficiency to statin myopathyAtherosclerosis, 2011
- Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trialsThe Lancet, 2010
- Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive ProteinThe New England Journal of Medicine, 2008
- Risks Associated With Statin TherapyJournal of the American College of Cardiology, 2006
- Enzymes involved in the activation and inactivation of vitamin DTrends in Biochemical Sciences, 2004
- Validation of the brief pain inventory for chronic nonmalignant painThe Journal of Pain, 2004
- MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebocontrolled trialThe Lancet, 2002