Analysis of vitamin d levels in patients with and without statin-associated myalgia – A systematic review and meta-analysis of 7 studies with 2420 patients☆
International Journal of Cardiology
Marta Michalska-Kasiczak, Amirhossein Sahebkar, Dimitri P. Mikhailidis, Jacek Rysz, Paul Muntner, Peter P. Toth, Steven R. Jones, Manfredi Rizzo, G. Kees Hovingh, Michel Farnier, Patrick M. Moriarty, Vera A. Bittner, Gregory Y.H. Lip, Maciej Banachemail, Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group
Received: September 11, 2014; Accepted: October 21, 2014; Published Online: October 22, 2014
DOI: http://dx.doi.org/10.1016/j.ijcard.2014.10.118
Introduction
Vitamin D (vit D) deficiency may be associated with an increased risk of statin-related symptomatic myalgia in statin-treated patients. The aim of this meta-analysis was to substantiate the role of serum vitamin D levels in statin-associated myalgia.
Methods
The search included PUBMED, Cochrane Library, Scopus, and EMBASE from January 1, 1987 to April 1, 2014 to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. Two independent reviewers extracted data on study characteristics, methods and outcomes. Quantitative data synthesis was performed using a fixed-effect model.
Results
The electronic search yielded 437 articles; of those 20 were scrutinized as full texts and 13 studies were considered unsuitable. The final analysis included 7 studies with 2420 statin-treated patients divided into subgroups of patients with (n =666 27.5%) or without (n =1754) myalgia. Plasma vit D concentrations in the symptomatic and asymptomatic subgroups were 28.4 ± 13.80 ng/mL and 34.86 ± 11.63 ng/mL, respectively. The combination of data from individual observational studies showed that vit D plasma concentrations were significantly lower in patients with statin-associated myalgia compared with patients not manifesting this side effect (weighted mean difference −9.41 ng/mL; 95% confidence interval: −10.17 to −8.64; p <0.00001).
Conclusions
This meta-analysis provides evidence that low vit D levels are associated with myalgia in patients on statin therapy. Randomized controlled trials are necessary to establish whether vitamin D supplementation reduces the risk for statin-associated myalgia.
See also VitaminDWiki
- Statins and Vitamin D - many studies
- Statin-induced Myalgias corrected with 100,000 weekly Vitamin D
- Statin pain eliminated by taking 50,000 IU vitamin D weekly – July 2011
- Breast cancer 2X more likely if have taken statins for 10 years – July 2013 - due to lower level of vitamin D caused by the statins
- Diseases that may be related via low vitamin D which has the following chart