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Association Between Vitamin D and Statin-Related Myopathy: A Meta-analysis

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Abstract

Background

Myopathy is the most widely reported statin-associated adverse event. Several studies have linked vitamin D deficiency with statin-related myopathy.

Objective

This meta-analysis aimed to investigate whether adult patients with statin-related myopathy have a lower 25-hydroxyvitamin D (25OHD) level than patients without myopathy and whether statin-related myopathy in vitamin D-deficient patients can be improved by vitamin D supplementation.

Methods

PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until 28 September 2020. Original studies comparing the 25OHD levels of patients with and without myopathy or detecting the impact of vitamin D supplementation on statin-related muscular intolerance were included. Subgroup analyses based on the sample size and baseline 25OHD level were conducted.

Results

This meta-analysis, based on nine cohort studies with a total of 2906 patients, revealed that the 25OHD level of patients with statin-related myopathy was significantly lower than that of patients without myopathy [weighted mean difference − 4.17 ng/mL; 95% confidence interval (CI) − 7.70 to − 0.63; p = 0.021]. The overall analysis from another four studies with 446 patients who were previously vitamin D deficient and reported statin-related muscular intolerance showed that the pooled tolerance rate of statins improved to 89% (95% CI 8692; p < 0.001) after vitamin D supplementation.

Conclusions

The present meta-analysis provides evidence that low 25OHD level is associated with statin-related myopathy and that exogenous vitamin D supplementation can improve statin-related muscular intolerance associated with low 25OHD level in most cases. Our findings may provide useful insight for the prevention and treatment of statin-related myopathy.

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Authors and Affiliations

  1. Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China

    Qingtao Hou

  2. Chongqing Medical University, Chongqing, 400016, China

    Caishuang Pang

  3. Neuroscience Research Center, College of Basic Medicine, Chongqing Medical University, Chongqing, 400016, China

    Yuqin Chen

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  1. Qingtao Hou
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Correspondence to Qingtao Hou.

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Funding

This work was supported by the National Natural Science Foundation of China under grant number 81901425.

Conflict of interest

Qingtao Hou, Caishuang Pang, and Yuqin Chen have no conflicts of interest that are directly relevant to the content of this article.

Availability of data and materials

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author contributions

QH designed the study and wrote the paper. QH and CP collected and analyzed the data. YC contributed to reference collection and data management. All authors read and approved the final manuscript.

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Hou, Q., Pang, C. & Chen, Y. Association Between Vitamin D and Statin-Related Myopathy: A Meta-analysis. Am J Cardiovasc Drugs 22, 183–193 (2022). https://doi.org/10.1007/s40256-021-00492-8

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