Azhar Yonis Ibrahim1,
Anwar Yonis Ibrahim2,
Nadheerah Falih Neamah1 
For correspondence:- Nadheerah Neamah Email: nadheerah.neamah@uobasrah.edu.iq
Received: 18 February 2026 Accepted: 18 May 2026 Published: 31 May 2026
Citation: Ibrahim AY, Ibrahim AY, Neamah NF. Dose-dependent and type-specific effects of statins on bone mineral density: The role of vitamin D and cholesterol. Trop J Pharm Res 2026; 25(5):657-663 doi: https://dx.doi.org/10.4314/tjpr.v25i5.7
© 2026 The authors.
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Purpose: To investigate dose-dependent and type-specific relationships between statin therapy and bone mineral density (BMD) as well as the effect of vitamin D and cholesterol levels on BMD. Methods: This was a cross-sectional study of 260 patients on statin therapy conducted at Al-Sader Teaching Hospital in Basrah, South of Iraq, from January 2022 to May 2022. Data on BMD were collated using Dual-Energy X-ray Absorptiometry (DEXA T-scores). Treatment regimen and socioeconomic characteristics were collected. Furthermore, lipid profiles and serum vitamin D levels were assessed. Results: The study comprised of 48.1 % male and 51.9 % females. The most administered statin was atorvastatin (55.8 %). Also, osteoporosis (48.1 %) and vitamin D deficiency (59.4 %) were frequent. Higher statin dosages (atorvastatin) (> 20 mg/day) significantly reduced mean DEXA T-scores (p < 0.05). High blood cholesterol and vitamin D levels were significantly negatively and positively correlated, respectively (p < 0.05) with BMD. Conclusion: High-dose atorvastatin significantly reduces BMD, with significant negative and positive correlation with cholesterol and vitamin D levels, respectively.
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