Association of Vitamin D and Incident Statin Induced Myalgia—A Retrospective Cohort StudyReportar como inadecuado

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Background and Objectives

Evidence is conflicting with regards to the role of vitamin D in statin induced myalgia SIM. Studies so far have assessed cross-sectional association and were limited by study sample selected predominantly from cardiology clinics. In this retrospective cohort study we assessed the association between vitamin D and SIM and attempted to establish a serum vitamin D cutoff to identify patients at risk for developing SIM.


Medical charts of 5526 consecutive patients from a primary care practice in Scranton, Pennsylvania from 2005–2012 were reviewed. Vitamin D level 25-hydroxy cholecalciferol at statin initiation was considered -Exposure level-. Vitamin D levels were categorized into quartiles ≤ 10, 11–20, 21–30, >30 ng-ml. SIM was identified by patient report.


1160 out of 5526 patients were treated with statins. The mean age was 55.9 years. 276 24% developed SIM. Unadjusted 7-yr cumulative incidences of SIM for quartiles 1–4 of vitamin D were 32.3, 21.5, 18.3 and 14.6% respectively. The lowest quartile of vitamin D was independently associated with 1.21 times the hazard of the fourth quartile for developing SIM 95% CI: 1.09, 1.33; P-trend  = 0.001. Vitamin D cut-off ≤15 ng-ml, showed a positive predictive value, negative predictive value, likelihood ratio LR + and LR- of 81, 90, 5.1 and 0.1, respectively for predicting SIM.


Low vitamin D level at statin initiation is associated with SIM, levels ≤15 ng-ml have a high predictive accuracy for SIM. Randomized controlled trials are needed to validate our results.

Autor: Ghanshyam Palamaner Subash Shantha, Julio Ramos, Linda Thomas-Hemak, Samir Bipin Pancholy



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