Simvastatin increases serum osteocalcin concentration in patients treated for hypercholesterolaemia

Animal studies, experimental models on cell lines, and epidemiological case -control studies have all suggested the possibility that 3-hydroxy-3-methyl glutaryl coenzyme A reductase inhibitors have a beneficial effect on bone m etabolism. However, all epidemiological studies are not prospective in natu re and based on either measurement of bone mineral density or fracture risk . They also differ in recruitment criteria, definition of statin exposure, and outcome assessment. We performed a first prospective study using specif ic biochemical bone markers on 17 hypercholesterolaemic non-osteoporotic su bjects treated with a therapeutic dose of simvastatin 20 mg daily for 4 wee ks. Our results show that serum osteocalcin concentration increased signifi cantly (p-value < 0.05) 4 weeks after therapy, whereas other bone markers i ncluding serum bone-specific alkaline phosphatase activity, urine deoxypyri dinoline, and urine cross-linked N-telopeptides of type I Collagen did not show any significant changes. Our data support that simvastatin causes a be neficial effect on bone metabolism as reflected by an increase in serum ost eocalcin concentration. This added beneficial effect of statins on bone met abolism could potentially allow statins to become the first effective anabo lic agent for the treatment of osteoporosis. We urge that priority should b e given to a randomised controlled study to re-evaluate this group of drugs .