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Int J Cardiol. 2015 Jan 15;178:111-6. doi: 10.1016/j.ijcard.2014.10.118. Epub 2014 Oct 22.

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.

Author information

1
Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland.
2
Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
3
Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK.
4
Department of Nephrology, Hypertension and Family Medicine, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland.
5
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
6
Preventive Cardiology, CGH Medical Center, Sterling, IL, USA; The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
7
The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
8
Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Italy.
9
Department of Vascular Medicine, Academic Medical Center, Amsterdam, Netherlands.
10
Department of Lipidology, Point Medical, Dijon, France.
11
Department of Medicine, Schools of Pharmacy and Medicine, The University of Kansas Medical Center, KS City, USA.
12
Division of Cardiovascular Disease, Preventive Cardiology Section, University of Alabama at Birmingham, Birmingham, AL, USA.
13
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK.
14
Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland. Electronic address: maciejbanach@aol.co.uk.

Abstract

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±13.80ng/mL and 34.86±11.63ng/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 -9.41ng/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.

KEYWORDS:

Myalgia; Statin intolerance; Statin-associated myalgia; Vitamin D

PMID:
25464233
DOI:
10.1016/j.ijcard.2014.10.118
[Indexed for MEDLINE]

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