Statins and hip fracture risk in men: a population based case control study.
PURPOSE To estimate the association between hydroxymethylglutaryl CoA inhibitor (statin) use and hip fracture. METHODS We conducted a population based case control study. Cases were 6774 male enrollees in a large managed care organization, aged 45 or more years, with an incident hip fracture from 1997 to 2006. Controls without fracture (n 6774) were matched to cases on age, race, and medical center. Electronic information on pharmaceutical use was used to identify the dispensing of statins from 1991 forward. RESULTS Overall, 1884 (27.8% cases and 2150 controls (31.7% used a statin before index date (matched odds ratio [mOR] 0.81, 95% confidence interval [CI] 0.74 0.87) Adjustment for comorbidity burden strengthened the magnitude of the overall association (mOR 0.68, CI 0.62 0.74) The adjusted association was similar across age groups but was strongest among men aged 80 years or more (mOR 0.62, CI 0.54 0.71) and was most pronounced in African Americans (mOR 0.43, CI 0.28 0.64) Greater duration of statin use did not alter the odds ratios. CONCLUSIONS These data add to the growing evidence of a potential protective effect of statin use on bone health. However, these results need to be replicated in a prospective study that can account for confounding by indication which may explain these findings.
Annals of epidemiology