Commentary: statins and fracture--why the confusion?

In 1999 a paper published in Science suggested that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) increased bone formation in rodents by effects on a potent bone forming cytokine bone morphogenetic protein-2 (BMP-2).1 Subsequent studies have suggested that statins increase bone mineral density (BMD) in humans2 and have investigated whether statin use is associated with reduced fracture risk.

[1]  Frank de Vries,et al.  Reanalysis of two studies with contrasting results on the association between statin use and fracture risk: the General Practice Research Database. , 2006, International journal of epidemiology.

[2]  J. Cauley,et al.  Use of statins and fracture: results of 4 prospective studies and cumulative meta-analysis of observational studies and controlled trials. , 2004, Archives of internal medicine.

[3]  Bent Ottesen,et al.  Issues to debate on the Women's Health Initiative (WHI) study. Epidemiology or randomized clinical trials--time out for hormone replacement therapy studies? , 2003, Human reproduction.

[4]  M. Koppán,et al.  Issues to debate on the Women's Health Initiative: estrogen: an instrument or the conductor of the orchestra? , 2003, Human reproduction.

[5]  C. Cooper,et al.  Use of statins and risk of fractures. , 2001, JAMA.

[6]  I. Reid,et al.  Effect of pravastatin on frequency of fracture in the LIPID study: secondly analysis of a randomised controlled trial , 2001, The Lancet.

[7]  H Jick,et al.  HMG-CoA reductase inhibitors and the risk of fractures. , 2000, JAMA.

[8]  C. Edwards,et al.  Oral statins and increased bone-mineral density in postmenopausal women , 2000, The Lancet.

[9]  S. Harris,et al.  Stimulation of bone formation in vitro and in rodents by statins. , 1999, Science.

[10]  A. LaCroix,et al.  Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. , 1998, JAMA.