Abstract Details

Title Vitamin D Insufficiency: A Risk Factor for Statin-Induced Myopathy

Topic Muscle Disease/Neuromuscular Junction

Presentation(s) P07 - (-)

Poster/Presentation
Number 042

Objective

Background BACKGROUND: The vitamin D receptor is present in skeletal muscle and vitamin D deficiency has been known to cause myalgia. Myopathy has been associated with statins and there is limited data to show interaction between vitamin D insufficiency and statin induced myopathy.

Design/Methods DESIGN/METHODS: We retrospectively collected data on 1089 consecutive patients who were on a statin with available baseline vitamin D levels, seen at our institution between Jan 2001 and Dec 2011. Patients were assigned into two groups based on presence of myopathy defined as presence of myalgia or serum CK levels > 3 x ULN. Patients with no baseline vitamin D levels and with myalgia or high serum CK secondary to other reasons were excluded. Using multivariate logistic regression we evaluated potential predictors of statin induced myopathy.

Results RESULTS: 244 patients in the myopathy group and 845 patients in control group were comparable for age (mean= 70.1/71.08 year, p<0.29), statin dose (mean= 37.58/38.36 mg, p<0.38) with significant difference in vitamin D level (mean= 20.9/26.13 ng/dl, p=<0.05) and serum CK levels (mean = 484.09/126.24 U/L, p<0.05). Among 244 patients in myopathy group 207(84.8%) had low vitamin D (OR 3.176; 95% CI 2.17- 4.63). Patients who were younger than 60 years, male or black in race showed a trend towards higher incidence of myopathy but were not significant (p=>0.05). By multivariate analysis low vitamin D level was the only independent predictor of statin induced myopathy.

Conclusions CONCLUSIONS: The study demonstrates a higher incidence of statin induced myopathy in patients with low vitamin D levels. Myalgia in statin-treated patients may reflect a reversible interaction between vitamin D deficiency and statins. This study suggests that screening for and treating vitamin D insufficiency may reduce the development of myopathy in patients placed on statins.

Authors/Disclosures
Atul Mangla, MD PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Barbara Teter, PhD MPH (SUNY-University of Buffalo Neurology)	No disclosure on file
Nicholas J. Silvestri, MD, FAAN (UBMD Neurology)	Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for argenx. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Regeneron. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunovant. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for argenx. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. The institution of an immediate family member of Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda. Dr. Silvestri has received publishing royalties from a publication relating to health care.

��ɫ��

��ɫ��