The effect of fluvastatin on parameters of bone remodeling

Statins decrease the hepatic biosynthesis of cholesterol, and reduce the in cidence of myocardial infarction in women who have already experienced a my ocardial infarction. Statins also reduce the risk of atherosclerosis in dia betic patients, but it is unknown whether they influence the glucose tolera nce. It has further been suggested that they may influence bone metabolism. Vitamin C is an antioxidant and it decreases serum cholesterol moderately. Antioxidants may also have other metabolic effects, but these are insuffic iently studied. The aim of the present study was to investigate the metabol ic effects of the cholesterol-lowering agent fluvastatin and the antioxidan t vitamin C. Sixty-eight elderly, postmenopausal women with osteoporosis an d mild hypercholesterolemia were randomly assigned to 12 weeks open treatme nt with either fluvastatin (40 mg daily) + 500 mg vitamin C (n=45) or vitam in C only (n=23). We measured biochemical markers of bone formation (serum osteocalcin and total alkaline phosphatase) and bone resorption (serum and urinary CTX), parameters related to diabetes and serum lipids and lipoprote ins. Fluvastatin in combination with vitamin C had no effect on bone format ion markers. We found a weak decrease in parameters of bone resorption, whi ch was significant from baseline, but not different between the two groups. There were no significant effects on any of the other markers of either fl uvastatin or vitamin C. The lipid-lowering effect of fluvastatin was confir med with a decrease of 20% and 30% in serum total cholesterol and LDL-chole sterol, respectively. We conclude that fluvastatin given in clinically rele vant doses has no influence on parameters of bone remodeling. Other statins remain to be investigated.