Effect of statins on skeletal muscle: exercise, myopathy, and muscle outcomes

Abstract

Statins are effective in reducing low-density lipoprotein cholesterol and cardiac events but can produce muscle side effects. We have hypothesized that statin-related muscle complaints are exacerbated by exercise and influenced by factors including mitochondrial dysfunction, membrane disruption, and/or calcium handling. The interaction between statins, exercise, and muscle symptoms may be more effectively diagnosed and treated as rigorous scientific studies accumulate.

Figures

Figure 1

Trends in statin drug use among adults in the United States are shown by age group (45–64, 65–74, and 75+ years of age) over three age ranges (1989–1994, 1999–2002, and 2005–2008). Data are self-report data (group means ± S.E.M.) from the National Health and Nutrition Examination Survey with statin use defined as taking a prescription statin over the past 30 day period. Data obtained from www.cdc.gov/nchs.

Figure 2

Serum CK levels (U/L) in men treated with 40 mg/day lovastatin (n=22) or placebo (n=27) before treatment (screen), after 4 weeks of lovastatin or placebo (pre-exercise on med.), and daily for 4 days after downhill walking. *P

Figure 3

Group means (± SD) of total CK before (Pre), immediately after (Finish), and 24 hours after the 2011 Boston Marathon (Post) in 37 individuals treated with statins and in 43 non-statin treated controls, including the p-value for the group-by-time interaction. * denotes a significant effect change relative to the baseline (pre) value at p

Figure 4

A schematic of the potential mechanisms by which statin therapy and exercise result in skeletal muscle damage.