Osteoporosis, bone & mineral

Age- and dose-dependent effect of statin use on the risk of osteoporotic fracture in older adults

Osteoporos IntPublished Retrospective cohort study

Main finding · Major osteoporotic fracturesResult — go to the resultAdjusted hazard ratio 0.77 95% CI 0.72–0.83

Authors' conclusion

Our results showed that statin use was associated with significant reduction in the risk of osteoporotic fractures in general older population.

Study context

Population
Older adults without previous history of osteoporosis, Korean National Health Insurance Service-Senior cohort database, observed until December 31 201254,959 osteoporotic fractures
Participants
365,656 adults
Exposure
Statin use vs non-use
Outcome
Major osteoporotic fractures
Methodological detailsnational health insurance database cohort, weighted Cox proportional hazards model, inverse-probability of treatment weighting
  • National health insurance database cohort
  • Weighted Cox proportional hazards model
  • Inverse-probability of treatment weighting

Main finding

As reported in the abstract

6.27 years of follow-up

Adjusted hazard ratio

0.77

95% CI 0.72–0.83

P < 0.001

Statin usersvs Non-users
adjusted HR 0.77 (95% CI 0.72–0.83); P < 0.001

Observational data: associations, not effects.

Further findings

OutcomeEstimateP value
Hip fracturesadjusted HR 0.49 (95% CI 0.38–0.62)P < 0.001
Vertebral fracturesadjusted HR 0.70 (95% CI 0.64–0.77)P < 0.001
Osteoporotic fracture by cumulative statin dose (cDDD)30-364 cDDDvs Non-usersHR 0.97 (95% CI 0.91–1.02)
Osteoporotic fracture by cumulative statin dose (cDDD)365-1,094 cDDDvs Non-usersHR 0.45 (95% CI 0.40–0.51)
Osteoporotic fracture by cumulative statin dose (cDDD)≥ 1,095 cDDDvs Non-usersHR 0.22 (95% CI 0.15–0.33)
  • Vertebral fractures: majority of fractures (69.5%) were vertebral fractures

By sex

Results broadly comparable in patterns of risk reduction by statin use

By age at statin initiation

Statin initiated at age ≥ 80 years had the highest risk reduction for most outcomes vs non-users

Original publication

Age- and dose-dependent effect of statin use on the risk of osteoporotic fracture in older adults. Osteoporos Int. Published 8 August 2023. doi:10.1007/s00198-023-06879-4

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