Statins have a tricky link to osteoporosis. A low dose offers protection against the bone-weakening condition, but high doses increase risk, a new study has found.

The results have immediate implications. Austrian investigators identified people who had taken statins for at least one year and divided them into groups by daily dosage. When the data was then filtered for osteoporosis diagnoses, the link was found, “In the lower-dose groups, there were fewer osteoporosis cases than expected,” wrote Alexandra Kautzky-Willer, M.D., of the Medical University of Vienna. 

At 10 milligrams or less, people taking the statins lovastatin, pravastatin, simvastatin or rosuvastatin were less likely to have an osteoporosis diagnoses when compared to participants who weren’t taking statin therapy. But at 20 milligrams or more, the higher the dosage, the greater the odds of osteoporosis. This was true for the drugs simvastatin, atorvastatin and rosuvastatin.

While clinical trials are the next logical step, “we can now advise high-risk osteoporosis patients undergoing statin therapy to have their bone metabolism regularly monitored,” said Kautzky-Willer.

The paper appears in the current issue of Annals of the Rheumatic Diseases.