Muscle Pain and Serum Creatine Kinase Are Not Associated With Low Serum 25(OH) Vitamin D Levels in Patients Receiving Statins

Clin Endocrinol (Oxf). 2012 Jul;77(1):36-41. doi: 10.1111/j.1365-2265.2011.04321.x.


Objective: Vitamin D deficiency has been associated in some studies with nonspecific musculoskeletal pain and, more specifically, with statin-induced myalgia, which was ameliorated by high-dose vitamin D supplements. Our objective was to explore the association between vitamin D status and statin-induced myalgia and elevation of serum creatine kinase (CK).

Design: Retrospective cohort study, based on the electronic database of a health maintenance organization.

Patients: Six thousand eight hundred and eight patients (71·5% women) to whom statins were dispensed during 2008 and who had ≥1 CK and 25-hydroxy vitamin D (25OHD) levels measured during statin exposure. Of these, 376 patients (5·5%) had switched from a first-line statin to atorvastatin because of muscle pain (n = 220) or other reasons (n = 156). Measurements; In the entire cohort, we compared serum CK levels among serum 25OHD quartiles. In addition, we compared CK and 25OHD levels among patients with myalgia, other switchers and nonswitchers.

Results: The median 25OHD level in the entire cohort was 21·8 ng/ml [interquartile range (IQR), 16·3-27·4]. CK levels were marginally lower in patients in the lowest 25OHD quartile [median CK (IQR) in 25OHD quartiles 1-4, 87 (61-130), 90 (65-131), 91 (65-132) and 91 (67-131) IU/ml, respectively; P = 0·007]. 25OHD levels in statin switchers were similar to those in nonswitchers; moreover, there were no differences in 25OHD among switchers with muscle pain and other switchers.

Conclusion: Our findings do not support an association between low 25OHD levels and statin-induced myalgia or CK elevation.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Anticholesteremic Agents / adverse effects
  • Anticholesteremic Agents / therapeutic use
  • Cohort Studies
  • Creatine Kinase / blood*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / drug therapy
  • Female
  • Heart Diseases / blood
  • Heart Diseases / drug therapy
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Middle Aged
  • Muscular Diseases / blood*
  • Muscular Diseases / chemically induced
  • Muscular Diseases / epidemiology
  • Musculoskeletal Pain / blood*
  • Musculoskeletal Pain / chemically induced
  • Musculoskeletal Pain / epidemiology
  • Retrospective Studies
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / chemically induced


  • Anticholesteremic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Vitamin D
  • 25-hydroxyvitamin D
  • Creatine Kinase