Our specific aims were to determine whether low serum 25 (OH) vitamin D (D2 + D3)
(<32 ng/mL) was associated with myalgia in statin-treated patients and whether the
myalgia could be reversed by vitamin D supplementation while continuing statins. After
excluding subjects who took corticosteroids or supplemental vitamin D, serum 25 (OH)
D was measured in 621 statin-treated patients, which consisted of 128 patients with
myalgia at entry and 493 asymptomatic patients. The 128 myalgic patients had lower
mean ± standard deviation (SD) serum vitamin D than the 493 asymptomatic patients
(28.6 ± 13.2 vs 34.2 ± 13.8 ng/mL, P < 0.0001), but they did not differ (p > 0.05) by age, body mass index (BMI), type 2 diabetes, or creatine kinase levels.
By analysis of variance, which was adjusted for race, sex, and age, the least square
mean (± standard error [SE]) serum vitamin D was lower in the 128 patients with myalgia
than in the 493 asymptomatic patients (28.7 ± 1.2 vs 34.3 ± 0.6 ng/mL, P < 0.0001). Serum 25 (OH) D was low in 82 of 128 (64%) patients with myalgia versus
214 of 493 (43%) asymptomatic patients (χ2 = 17.4, P < 0.0001). Of the 82 vitamin-D–deficient, myalgic patients, while continuing statins,
38 were given vitamin D (50,000 units/week for 12 weeks), with a resultant increase
in serum vitamin D from 20.4 ± 7.3 to 48.2 ± 17.9 ng/mL (P < 0.0001) and resolution of myalgia in 35 (92%). We speculate that symptomatic myalgia
in statin-treated patients with concurrent vitamin D deficiency may reflect a reversible
interaction between vitamin D deficiency and statins on skeletal muscle.
Abbreviations:
BMI (body mass index), CK (creatine kinase)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 08, 2008
Accepted:
November 7,
2008
Received in revised form:
November 5,
2008
Received:
October 15,
2008
Footnotes
Supported in part by the Lipoprotein Research Fund and the Medical Research Funds of the Jewish Hospital of Cincinnati.
Identification
Copyright
© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
