Statin use and 25-hydroxyvitamin D blood level response to vitamin D treatment of older adults

Authors: BISCHOFF-FERRARI, HEIKE - University Of Zurich; FISCHER, KARINA - University Of Zurich; ORAV, ENDEL - Harvard University; DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; MEYER, URSINA - University Of Zurich; CHOCANO-BEDOYA, PATRICIA - University Of Zurich; MEYER, OTTO - University Of Zurich; ERNST, RAHEL - University Of Zurich; SCHIETZEL, SIMEON - University Of Zurich; EBERLI, FRANZ - Triemli Hospital; STAHELIN, HANNES - University Of Basel; FREYSTATTER, GREGORY - University Of Zurich; ROAS, SUSANNE - University Hospital Zurich; THEILER, ROBERT - University Of Zurich; EGLI, ANDREAS - University Of Zurich; WILSON, NICHOAS - University Of Zurich

Submitted to: Journal of American Geriatric Society
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/6/2016
Publication Date: 2/27/2017
Citation: Bischoff-Ferrari, H., Fischer, K., Orav, E.J., Dawson-Hughes, B., Meyer, U., Chocano-Bedoya, P.O., Meyer, O.W., Ernst, R., Schietzel, S., Eberli, F., Stahelin, H.B., Freystatter, G., Roas, S., Theiler, R., Egli, A., Wilson, N.M. 2017. Statin use and 25-hydroxyvitamin D blood level response to vitamin D treatment of older adults. Journal of American Geriatric Society. doi: 10.1111/jgs.14784.

Interpretive Summary: Statins are drugs widely used to lower serum cholesterol levels. Several studies have suggested that use of statins may alter the effectiveness of vitamin D in raising serum 25-hydroxyvitamin D levels. To test this directly, we compared the change in 25-hydroxyvitamin D levels in response to supplementation with vitamin D between statin users and non-statin users over a 1 year period in 646 men and women aged 60 years and older. At baseline, 17.5% of the participants were taking a statin. We found that baseline 25-hydroxyvitamin D levels did not differ in the statin users and non-users but that the total increase over 12 months in 25-hydroxyvitamin D concentration was 21.4% lower among statin users than non-users. This difference was highly significant (p-value = 0.009.) We conclude that older adults who take statins may require higher doses of vitamin D to reach optimal 25-hydroxyvitamin D levels.

Technical Abstract: Objectives: To determine whether statin use alters response of 25-hydroxyvitamin D (25(OH)D) level to vitamin D treatment. Design: Pooled analysis. Setting: Three double-blind randomized controlled trials that tested different doses of vitamin D. Participants: Participants of three trials (N = 646; mean age 76.3 +/- 8.4, 65% female). Measurements: In all three trials, 25(OH)D status and statin use were assessed repeatedly over time (baseline, 6 and 12 months). Repeated-measures analysis was used to compare 25(OH)D response to vitamin D treatment at baseline and 6 and 12 months of statin users and nonusers, controlling for age, sex, body mass index, Charlson Comorbidity Index, vitamin D dose, trial, and season. Results: At baseline, 17.5% were statin users, and 65% were vitamin D deficient (25(OH)D < 20 ng/mL). Baseline 25(OH)D levels did not differ significantly between groups at baseline (18.8 for statin users, 17.2 ng/mL for nonusers, P = .07), but according to the longitudinal analyses, the total increase over 12 months in 25(OH)D concentration was significantly lower in statin users (13.1 ng/L) than nonusers (15.9 ng/mL; 21.4% difference; P = .009). Conclusion: Of persons aged 60 and older at high risk of vitamin D deficiency, statin users had a 21.4% smaller increase in 25(OH)D serum concentrations over time than nonusers, independent of vitamin D dose and other covariates.