The effects of improved metabolic risk factors on bone turnover markers after 12 weeks of simvastatin treatment with or without exercise

• Published in: Metabolism, clinical and experimental Vol. 63; no. 11; pp. 1398 - 1408
• Main Authors: Jiang, Jun, Boyle, Leryn J, Mikus, Catherine R, Oberlin, Douglas J, Fletcher, Justin A, Thyfault, John P, Hinton, Pamela S
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2014; Elsevier
• Subjects: Absorptiometry, Photon; Adult; Aerobic exercise; Biological and medical sciences; Biomarkers - blood; Bone Remodeling; Bone turnover markers; Endocrinology & Metabolism; Exercise; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Male; Metabolic risk factors; Metabolic Syndrome - drug therapy; Metabolic Syndrome - physiopathology; Middle Aged; Patient Compliance; Risk Factors; Simvastatin; Simvastatin - therapeutic use; The metabolic syndrome; Vertebrates: anatomy and physiology, studies on body, several organs or systems; CTX; high-density lipoprotein; dual energy X-ray absorptiometry; Metabolic risk factors; bone mineral density; ANCOVA; HDL; analysis of variance; OC; The metabolic syndrome; ANOVA; LDL; BMD; BMI; bone specific alkaline phosphatase; body mass index; Simvastatin; HMG-CoA; triglycerides; DXA; low-density lipoprotein; BAP; hydroxy-3-methyl glutaryl coenzyme A; C-terminal peptide of type I collagen; osteocalcin; TAG; analysis of covariance; Bone turnover markers; Aerobic exercise; Physical exercise; Enzyme; Enzyme inhibitor; Statin derivative; Marker; Hypocholesterolemic agent; Osteoarticular system; Metabolic disorder; Treatment; HMG-CoA reductase inhibitor; Turnover; Hydroxymethylglutaryl-CoA reductase; Oxidoreductases; Bone; Endocrinology; Antilipemic agent
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2014.07.011

Abstract Objective Emerging evidence supports an association between metabolic risk factors and bone turnover. Statins and exercise independently improve metabolic risk factors; however whether improvements in metabolic risk factor affects bone turnover is unknown. The purpose of the present study was to: 1) evaluate the relationship between metabolic risk factors and bone turnover; and 2) determine if improvements in metabolic risk factors after 12 weeks of statin treatment, exercise or the combination affect bone turnover. Methods Fifty participants with ≥ 2 metabolic syndrome defining characteristics were randomly assigned to one of three groups: statin (STAT: simvastatin, 40 mg/day), exercise (EX: brisk walking and/or slow jogging, 45 minutes/day, 5 days/week), or the combination (STAT + EX). Body composition and whole body bone mineral density were measured with dual energy X-ray absorptiometry. Serum markers of bone formation (bone specific alkaline phosphatase, BAP; osteocalcin, OC), resorption (C-terminal peptide of type I collagen, CTX) and metabolic risk factors were determined. Two-factor (time, group) repeated-measures ANCOVA was used to examine changes of metabolic risk factors and bone turnover. General linear models were used to determine the effect of pre-treatment metabolic risk factors on post-treatment bone turnover marker outcomes. Results Participants with ≥ 4 metabolic syndrome defining characteristics had lower pre-treatment OC than those with 3 or fewer. OC was negatively correlated with glucose, and CTX was positively correlated with cholesterol. STAT or STAT + EX lowered total and LDL cholesterol. The OC to CTX ratio decreased in all groups with no other significant changes in bone turnover. Higher pre-treatment insulin or body fat predicted a greater CTX reduction and a greater BAP/CTX increase. Conclusion Metabolic risk factors were negatively associated with bone turnover markers. Short-term statin treatment with or without exercise lowered cholesterol and all treatments had a small effect on bone turnover.