[Statins and osteoporosis]

Abstract

3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, statins are potent inhibitors of cholesterol biosynthesis. Cholesterol-lowering therapy using statins significantly reduces the risk of coronary heart disease. Furthermore, wider use of statins leads to increases of other beneficial effects, so-called pleiotropic effects. These include reductions in cytotoxicity and inflammation reaction, oncoprotective effects - apoptosis of some types of cancer cells, improvement of endothel function, inhibition of thromb formation, decrease of the risk of dementia independent of improvement in the lipid spectrum, inibition of smooth muscle cells proliferation and inhibition of thrombocyte aggregation. One of the important effects is its influence on bone metabolism. Statins augment the expression of bone morphogenetic protein-2, a potent stimulator of osteoblast differentiation and its activity, and promote mineralization by cultured osteoblasts, indicating that statins have an anabolic effect on bone. The author has attempted to summarize the most recent theories on the mechanism of this effect and summarises studies that have been carried out, albeit with inconsistent results.