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Simvastatin acts as a double therapeutic weapon by blocking the conversion of HMG-CoA to mevalonate. Not only does this action increase new bone formation via the stimulation of osteoblasts , but it also prevents the production of cholesterol.
Nagwa Lachine, MD, Department of Internal Medicine, Alexandria University, Egypt, presented the study.
To determine the effects of statins on the bone mineral density (BMD), Dr. Lachine and associates conducted a 3-month investigation on 2 statin agents — simvastatin and pravastatin — administered to 30 postmenopausal women with type 2 diabetes mellitus and osteoporosis. None of the participants had a medical history of bone metabolism disorders.
The women were divided into 2 groups. Group 1 consisted of 15 patients who received simvastatin 40 mg/day. Group 2 consisted of 15 women who received pravastatin 40 mg/day.
Before and after the trial, each patient was evaluated for levels of fasting and post-prandial plasma glucose, glycosylated haemoglobin, alanine aminotrasferase (ALT), cholesterol, triglycerides, total and ionized calcium, as well as phosphorous.
Dual energy X-ray absorptiometry was used to evaluate the bone mineral density of the forearm and L2-L3 lumbar vertebrae. In addition, the researchers measured serum osteocalcin, a marker for bone formation, and urinary deoxypyridinoline (DPD), a marker for bone resorption.
"This information was crucial because bone mass is determined by the balance of bone formation to bone resorption," Dr. Lachine said.
Among the group that received simvastatin, there was a considerable increase in serum osteocalcin and BMD, as well as a substantial decrease in urinary DPD.
The pravastatin group had insignificant changes in osteocalcin, DPD, and bone mineral density. As expected, both statins caused a reduction in serum cholesterol and triglycerides. There were no abnormal changes in ALT levels among either group.
Dr. Lachine explained that simvastatin acts as a double therapeutic weapon by blocking the conversion of HMG-CoA to mevalonate. Not only does this action increase new bone formation via the stimulation of osteoblasts, but it also prevents the production of cholesterol.
Dr. Lachine said that simvastatin has a promising role in the fight against osteoporosis, but additional studies are needed to determine the effective dosage and mode of administration.
[Study title: Statins: A Double Weapon in Treating Dyslipidemic Osteoporotic Menopausal Type 2 Diabetes. Abstract 2P-0417]
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