Statin therapy and the risk of osteoporotic fractures in patients with metabolic syndrome: A nested case-control study

Kyoung Jin Kim, Jimi Choi, Ji Yoon Kim, Jae Hyun Bae, Kyeong Jin Kim, Hee Young Kim, Hye Jin Yoo, Ji A. Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim

Research output: Contribution to journalArticlepeer-review


Objective: We aimed to investigate the association between statin use and the risk of major osteoporotic fractures in patients with metabolic syndrome (MetS). Methods: A nested case-control study was performed in patients with MetS (≥50 years) who had no history of osteoporotic fracture using the Korean National Health Insurance Service-Health Screening Cohort. This study included 17,041 patients diagnosed with new-onset osteoporotic fractures and controls matched in a 1:1 ratio by age, sex, body mass index, cohort entry date, and follow-up duration. Conditional logistic regression analysis was used to evaluate covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: During a 4-year follow-up period, the risk of major osteoporotic fractures was significantly reduced by 9% (OR, 0.91; 95% CI, 0.85–0.97) in statin users compared with that in non-users. Among subtypes of major osteoporotic fracture, a risk reduction with statin therapy was significant for vertebral fracture (OR, 0.86; 95% CI, 0.79–0.94) but not for non-vertebral fracture (OR, 0.97; 95% CI, 0.88–1.06). Longer duration (OR, 0.97; 95% CI, 0.96–0.99, per 1-year increase) and higher cumulative dose (OR, 0.97; 95% CI, 0.95–0.99, per 365 defined daily doses) of statins were negatively associated with the risk of major osteoporotic fracture. Conclusion: This study supports the hypothesis that statin therapy has a beneficial effect on major osteoporotic fractures, especially vertebral fractures, in patients with MetS.

Original languageEnglish
Pages (from-to)322-333
Number of pages12
JournalJournal of Lipid and Atherosclerosis
Issue number3
Publication statusPublished - 2021 Sep
Externally publishedYes


  • Case-control studies
  • HMG-CoA reductase inhibitor
  • Metabolic syndrome
  • Osteoporotic fractures
  • Statin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine


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