Effects of atorvastatin on bone mineral density (BMD) and bone metabolism in elderly males with osteopenia and mild dyslipidemia: A 1-year randomized trial

• First randomized controlled study in elderly male in detecting atorvastatin on bone health.
• Therapeutic doses of atrovastatin were associated with protective effects on BMD.
• The underlying effects were probably mediated by suppressed bone resorption.

We explored the effects of atorvastatin on BMD and biochemical markers of bone metabolism in a 1-year, prospective, randomized controlled study. 64 male patients with osteopenia and mild dyslipidemia (mean age 80.1 ± 6.6 years) were randomized to a 1-year atorvastatin treatment or control. BMD of hip and lumbar spine was measured with dual-energy X-ray absorptionmetry (DXA). Bone metabolic markers including resorption markers β-c-terminal telopeptide of type I collagen (CTx), formative markers osteocalcin (OC), 25-hydroxyvitamin D (25(OH)D) were measured with electrochemiluminescence immunoassay (ECLIA). Other bone metabolism markers including intact parathyroid hormone (iPTH) and testosterone were measured with chemiluminescence enzyme immunoassay (CLEIA). Levels of serum lipid and biochemical parameters were measured with automatic biochemical analyzer. All the parameters were recorded at baseline, and at 6 and 12 months, respectively. Compared with the control group, the atorvastatin treatment group showed significant reduction of triglyceride (TG, P < 0.01) and low-density lipoprotein cholesterol (LDL-C, P < 0.01). At 12 month, total hip BMD in atorvastatin group was significantly higher (P < 0.01) compared with the control group, while there were no similar effect on femoral neck or lumbar spine between the two groups (P = 0.48 and 0.53 respectively). Meanwhile, CTx significantly reduced in atorvastatin treatment group (P < 0.001) compared with baseline. Our findings suggest that in elderly male patients with osteopenia and mild dyslipidemia, therapeutic doses of atorvastatin were associated with positive effects on BMD, probably mediated by suppressed bone resorption.