Cross-sectional and longitudinal associations between statin use and bone density: the Manitoba BMD registry

Statins are among the most widely prescribed medications in older individuals. Inconsistent data in humans suggest that statin medications may be associated with greater BMD and lower risk for osteoporosis. We identified 22 393 individuals aged 40 yr and older undergoing initial (Visit 1) and repeat (Visit 2) TH BMD measurement within 1-10 yr total from DXA through the Manitoba BMD Program (February 28, 1999 to March 29, 2018). Linked medication records showed that 4119 (18.3%) of the study population were statin users at Visit 1 and 6667 (29.8%) were statin users at Visit 2. There was inconsistent and largely negative evidence for prior statin use affecting initial TH BMD measurement or BMD change during follow-up. Even among those with the greatest exposure (mean 5.1 yr of prior statin use with high adherence), the observed effects on covariate-adjusted initial TH BMD or annualized change in TH BMD change did not show clinically significant differences. In summary, this large observational analysis, which included both cross-sectional and longitudinal components, failed to detect a clinically meaningful benefit of statin exposure on bone density, even when taken with high adherence over several years.