Wheelchair use and lipophilic statin medications may influence bone loss in chronic spinal cord injury: Findings from the FRASCI-bone loss study

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Study assessed clinical and demographic characteristics associated with change in bone density over a mean of 21 months in 152 men and women with chronic spinal cord injury (SCI) who were enrolled in the Fracture Risk after SCI (FRASCI) study. The association between statin use and bone loss following paralysis was also examined. A mixed-model procedure with repeated measures was used to assess predictors of change in bone mineral density at the distal femur and proximal tibia. No association was found between bone loss and traditional osteoporosis risk factors, including age, gender, body composition, or vitamin D level or status (normal or deficient). In both crude and fully adjusted models, wheelchair users lost bone compared to walkers. Similarly, lipophilic statin users gained bone at the knee compared to non-users. Results suggest that both walking and statins may be effective osteogenic therapies to mitigate bone loss and prevent osteoporosis in people with chronic SCI. The findings also suggest that loss of mechanical loading and/or neuronal factors contribute to disuse osteoporosis more than traditional osteoporosis risk factors.

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