Cholestatic jaundice induced by atorvastatin

This paper was published in the Israel Medical Association Journal 2009 Jul;11(7):440-1

Study title and authors:
Cholestatic jaundice induced by atorvastatin: a possible association with antimitochondrial antibodies.

Minha S, Golzman G, Adar I, Rapoport M.
Department of Internal Medicine C, Assaf Harofeh Medical Center, Zerifin, Israel. Minha.saar@gmail.com

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/19911499

This paper describes the case of a man who developed cholestatic jaundice while taking atorvastatin. (Cholestatic jaundice is when the normal flow of bile from the liver to the small intestine is interupted).

(i) A 68 year old man was admitted to hospital complaining of fever, dark urine and hives (itchy rash).
(ii) He was taking atorvastatin 20 mg per day.
(iii) Physical examination revealed he had jaundice and large areas of hives.
(iv) Abnormal laboratory results included elevated liver function tests with a cholestatic pattern:
total bilirubin 7.4 mg/dl (normal 0.2–1.0 mg/dl)
alkaline phosphatase 555 U/L (normal 39–117 U/L)
alanine aminotransferase 250 U/L (normal 4–41 U/L)
aspartate aminotransferase 50 U/L (normal 5–38 U/L)
lactate dehydrogenase 540 U/L (normal 240–480 U/L)
(v) A diagnosis of drug-induced liver damage was made.
(vi) The patient stopped taking atorvastatin and he had a rapid biochemical and clinical improvement.
(vii) During the following four weeks the patient was discharged and readmitted twice with a similar clinical and laboratory findings.
(viii) A liver biopsy revealed on his next admission revealed severe inflammation.
(ix) Further investigation revealed that between admissions and prior to each recurrent bout of cholestatic hepatitis the patient had renewed his treatment with atorvastatin.  
(x) Complete cessation of atorvastatin was followed by a return to normal values of liver function tests and a complete clinical recovery.

High fat diets boost calcium absorption

This study was published in the American Journal of Clinical Nutrition 2000 Aug;72(2):466-71

 

Study title and authors:

Factors associated with calcium absorption efficiency in pre- and perimenopausal women.

Wolf RL, Cauley JA, Baker CE, Ferrell RE, Charron M, Caggiula AW, Salamone LM, Heaney RP, Kuller LH.

Departments of Epidemiology, Education, and Genetics, University of Pittsburgh, USA. wolf@exchange.tc.columbia.edu

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/10919942

 
Wolf notes that low calcium is linked to high blood pressure, colorectal cancer, bone loss and the risk of osteoporosis.

The purpose of this study was to examine factors that affect the efficiency of calcium absorption in women. The study included 142 healthy pre- and perimenopausal women, aged 46-54 years, (93.7% were premenopausal).

The study found:
(a) Women who consumed the most fat, absorbed calcium more efficiently than women who consumed the least fat.
(b) Women who consumed the least fibre, absorbed calcium more efficiently than women who consumed the most fibre.
(c) Women who consumed diets with the lowest ratio of fat to fibre had 19% lower calcium absorption values than did women who consumed diets with the highest ratio of fat relative to fibre.
(d) Women who had the highest vitamin D levels, absorbed calcium more efficiently than women with the lowest vitamin D levels. (Vitamin D is only found in food of animal origin such as lard, fish, butter and egg yolks).

The results of the study show that a high-fat diet helps women to efficiently absorb calcium.

Statin use linked to musculoskeletal diseases, joint pain and injuries

This study was published in the Journal of the American Medical Association Internal Medicine 2013:1-9

Study title and authors:
Statins and Musculoskeletal Conditions, Arthropathies, and Injuries
Ishak Mansi, MD; Christopher R. Frei, PharmD, MSc; Mary Jo Pugh, PhD; Una Makris, MD; Eric M. Mortensen, MD, MSc

This study can be accessed at: http://archinte.jamanetwork.com/article.aspx?articleid=1691918

The objective of the study was to determine whether statin use is associated with musculoskeletal disorders. ( Musculoskeletal disorders can affect the body's muscles, joints, tendons, ligaments and nerves). This analysis compared 6,967 statin users with 6,967 nonusers.

The study found:
(a) Statin users had a 19% increased risk of all musculoskeletal diseases compared to nonusers.
(b) Statin users had a 13% increased risk of injury-related diseases (dislocation, sprain, strain) compared to nonusers.
(c) Statin users had a 9% increased risk of drug-associated musculoskeletal pain compared to nonusers.
(d) Statin users had a 7% increased risk of joint pain compared to nonusers.

Mansi concludes: "Musculoskeletal conditions, arthropathies, injuries, and pain are more common among statin users than among similar nonusers".

Polyunsaturated fat associated with bone mineral loss whereas saturated fat may offer protection

This study was published in the American Journal of Clinical Nutrition 2004 Jan;79(1):155-65

 

Study title and authors:

Nutritional associations with bone loss during the menopausal transition: evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids.

Macdonald HM, New SA, Golden MH, Campbell MK, Reid DM.

Department of Medicine and Therapeutics, University of Aberdeen, United Kingdom. h.macdonald@abdn.ac.uk

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/14684412

The menopausal transition is characterised by rapid bone loss. The objective of the study was to ascertain which dietary factors influence skeletal loss around the time of the menopause. In the study, the bone mineral density was measured at the start of the study and five years later in 891 women initially aged 45-55.

Regarding fat intake, the study found:
(a) A higher intake of saturated fat was correlated with a protective effect from bone mineral loss.
(b) A higher intake of polyunsaturated fat was correlated with lower bone mineral density

Long-term statin treatment may be associated with chronic peripheral neuropathy

This paper was published in the European Journal of Clinical Pharmacology 1999 Jan;54(11):835-8

 

Study title and authors:

Statins and peripheral neuropathy.

Jeppesen U, Gaist D, Smith T, Sindrup SH.

Department of Neurology, Odense University Hospital, Denmark.

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/10027656

This paper reports of seven cases of peripheral neuropathy associated with long-term statin therapy.

(i) Diagnosis of neuropathy by statin therapy was confirmed after all other causes of neuropathy were thoroughly excluded.
(ii) Neuropathy symptoms manifested up to seven years after initiation of statin therapy.
(iii) In all seven cases the neuropathy affected the nerve fibres and with affection of both thick and thin nerve fibers.
(iv) The symptoms of neuropathy persisted during an observation period lasting from 10 weeks to one year in four cases after statin treatment had been withdrawn.

Jeppesen concluded: "Long-term statin treatment may be associated with chronic peripheral neuropathy".

High saturated fat and cholesterol consumption associated with a slight decreased risk of Parkinsons

This study was published in the American Journal of Epidemiology 2003 Jun 1;157(11):1007-14

 

Study title and authors:

Dietary intakes of fat and risk of Parkinson's disease.

Chen H, Zhang SM, Hernán MA, Willett WC, Ascherio A.

Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. hchen@hsph.harvard.edu

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12777364

This study investigated the associations between fat intakes and risk of Parkinson's disease. The study included 135,894 subjects who were followed for up to 18 years.

The data from the study found:
(a) Those that consumed the most animal fat had a 2% decreased risk of Parkinson's compared to those who consumed the least animal fat.
(b) Those that consumed the most saturated fat had a 1% decreased risk of Parkinson's compared to those who consumed the least saturated fat.
(c) Those that consumed the most cholesterol had a 5% decreased risk of Parkinson's compared to those who consumed the least cholesterol.

High saturated fat and cholesterol consumption associated with a slight decreased risk of Parkinsons.

Muscle disease is a dangerous side-effect of statin drugs

This paper was published in Ugeskrift for Laeger 2010 Feb 15;172(7):544-5

 

Study title and author:

Statin-induced dysphagia

Edholm B.

Øre-naese-halskirurgisk Afdeling, Slagelse Sygehus, DK-5000 Odense C, Denmark. bjarkeedholm@hotmail.com

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/20156405

Dysphagia is the medical term for swallowing difficulties.

The paper reports on a man who developed dysphagia and muscle fatigue after statin therapy.

(i) A 68-year-old man was referred to hospital with progressive dysphagia.
(ii) The patient further developed muscle fatigue (it was difficult for him to lift his arms above his head) and additional signs of myopathy (muscle disease) such as high levels of creatine kinase.
(iii) The dysphagia was diagnosed as a late-onset side-effect of statin therapy.
(iv) He stopped taking statins and 14 days later the power to his arms returned, his swallowing function was significantly better and his creatine kinase levels normalised.

The author of the paper, Bjarke Edholm from the Slagelse Hospital in Denmark, concluded: "As an increasing number of patients are being treated with lipid-lowering drugs (statins), it is important to recall that myopathy is a dangerous side-effect which may have either quick or delayed onset, and that dysphagia can be the initial symptom".