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Low Vitamin D Levels and Genetic Polymorphism in the Vitamin D Receptor are Associated with Increased Risk of Statin‐Induced Myopathy
Author(s) -
Ovesjö MarieLouise,
Skilving Ilona,
Bergman Peter,
Rane Anders,
Ekström Lena,
BjörkhemBergman Linda
Publication year - 2016
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.12482
Subject(s) - myopathy , taqi , medicine , calcitriol receptor , vitamin d and neurology , statin , foki , gastroenterology , endocrinology , prospective cohort study , allele , polymorphism (computer science) , biology , genetics , gene
Abstract The main aim of this study was to test the hypothesis whether 25‐hydroxyvitamin D (25 OHD ) levels <50 nmol/L at baseline could predict statin‐induced myopathy during the course of treatment. In addition, we analysed the association between a genetic polymorphism in the vitamin D receptor ( VDR ) and the risk of statin‐induced myopathy. We used serum samples from a prospective, observational study in statin‐treated patients in Sweden who were thoroughly followed with interviews and questionnaires regarding muscular symptoms (n = 127). In this cohort, 16 developed muscular symptoms and 111 had no muscular symptoms associated with statin treatment during the first year of follow‐up. Patients with 25 OHD levels <50 nmol/L before starting on statin treatment had four times higher risk of developing muscular symptoms compared with individuals having 25 OHD levels >50 nmol/L ( RR 4.2; 95% CI 1.7–10.2; p < 0.01). The mean levels of 25 OHD at baseline were 50 ± 4 nmol/L among patients developing myopathy and 60 ± 2 nmol/L among patients without myopathy ( p < 0.01). Individuals homozygous for the C allele in the VDR polymorphism TaqI (rs731236) had a four times higher risk of developing muscular symptoms; ( RR 4.37, 95% CI 1.9–10.1, p < 0.01). In conclusion, 25 OHD levels <50 nmol/L might be a useful marker to predict muscular adverse events during statin treatment. In addition, the finding that the VDR polymorphism TaqI was associated with myopathy may indicate a causal relationship between vitamin D function and myopathy, but larger studies are needed before firm conclusions can be drawn.