Association of pitavastatin use with bone markers and bone mineral density in postmenopausal women

BACKGROUND The study aimed to evaluate the effects of pitavastatin therapy on biochemical markers of bone turnover and bone mineral density (BMD) in postmenopausal women with osteopenia or osteoporosis and hypercholesterolemia. METHODS AND RESULTS This prospective observational study recruited 70 postmenopausal Korean women who were administered pitavastatin. Changes in BMD at the femoral neck (FN), total hip (TH), and lumbar spines (LS), as well as laboratory values related to bone turnover markers and lipid profiles, including lipoprotein subfractions, were assessed over 12 months. BMD was further observed during regular clinic visits up to 4 years. A total of 67 patients completed 12 months of pitavastatin therapy. There were no significant changes in BMD (–0.001 ± 0.026 at FN, –0.005 ± 0.032 at TH, and 0.002 ± 0.037 at LS; all Ps > 0.05). Bone markers did not change except for procollagen type 1 N-propeptide (P1NP), which slightly decreased (–4.0 ± 10.3, P < 0.05). Low-density lipoprotein (LDL) cholesterol levels decreased by 36% to 39% from baseline, and the LDL subfraction score decreased from 2.85 ± 1.79 to 1.80 ± 0.63 ( P < 0.001). During the extended observation period, BMD at FN and TH decreased by 0.85% and 1.69% per year, respectively, while BMD at the LS was preserved. CONCLUSIONS In postmenopausal women with osteopenia or osteoporosis requiring lipid-lowering therapy, one year of pitavastatin maintained BMD and effectively controlled cholesterol levels. BMD changes during statin therapy were more favorable than the natural decline. These findings suggest pitavastatin can be safely used in menopausal women without compromising bone health.