Association Between Cortical Bone Microstructure and Statin Use in Older Women

Context: Treatment with statins has been associated with increased bone mineral density, but whether this association depends on differences in cortical or trabecular volumetric bone microstructure is unknown. Objective: The aim of this study was to investigate if treatment with statins is associated with bone microstructure and geometry in older women. Design Setting and Participants: Older women were included in a population-based study of 3028 women (mean age +/- SD, 77.8 +/- 1.6 years) from the greater Gothenburg area in Sweden. Information regarding medical history, medication, and lifestyle factors was obtained from validated questionnaires. Main Outcome: Bone geometry and microstructure were measured at the ultradistal and distal (14%) site of radius and tibia using high-resolution peripheral quantitative computed tomography. Results: The 803 women in the cohort who used statins had higher body weight, worse physical function, and more frequent cardiovascular disease and diabetes than nonusers (P < 0.05). Statin users had lower cortical porosity (radius, 2.2 +/- 1.9 vs 2.5 +/- 2.0%; tibia, 5.2 +/- 2.4 vs 5.4 +/- 2.5; P = 0.01), higher cortical bone density (radius, 1008 +/- 39.1 vs 1001 +/- 38.4 mg/cm(3 ); tibia, 919 +/- 42.6 vs 914 +/- 41.5; P < 0.01), and greater cortical area (radius, 60.5 +/- 9.6 vs 58.6 +/- 9.7 mm(2); tibia, 150.0 +/- 23.6 vs 146.7 +/- 23.8; P < 0.01) than nonusers after adjustment for a large number of confounders, including age, weight, smoking, other medications, and prevalent diseases. Conclusions: Use of statins was associated with better cortical bone characteristics in older women.