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The Relation of Vitamin D Blood Level with Statin-Associated Muscle Symptoms (SAMS)

Aims: This work evaluates the vitamin D status in patients with statins- associated muscle symptoms. 
Study Design:  A case control prospective study. 
Place and Duration of Study:  Neurology Department, Mansoura University, Mansoura, Egypt, between June 2020 and May 2021. 
Methodology: Total of 85 participants included in this study, 60 participants of them have chronic Stroke and ischemic heart disease, treated by different kinds of statins and 25 participants were healthy controlled individuals. The 60 patients were 35 males (55%) and 25 females (45%), with age ranging from 40 to 70 years. The 60 participants were divided into two groups: The first group included (30 patients) treated with statins and they did not have Statin-Associated Muscle Symptoms (SAMS).The second group included (30 patients) also treated with Statin and they complained of SAMS. The third group is the control group, which contains the 25 participants who were healthy people. The control group included15 males (55%) and 10 females (45%) with age ranged from 35 to 65 years. Laboratory investigations were conducted on all participants in this study. The participants were subjected to total of 5 laboratory tests, which include: (1) Vitamin D (Enzyme immunoassay method), (2) Total CK (Enzymatic method), (3) Total Cholesterol and Triglycerides (Enzymatic method), (4)High density lipoproteins Cholesterol (Precipitation method), (4)Low density lipoproteins Cholesterol (Freid Wald equation), and (5) C – reactive protein (CRP: Latex Agglutination Method) was done beside elecetrophysiology study ( Needle electromyography (NEMG) was include). 
Results: Out of 60 patients the statistical readings of Vitamin D levels for the studied groups, demonstrating a significant statistical difference in Vitamin D levels between patients complaining of statin-associated muscle symptoms group (P≤0.001), and the other groups with lowest mean of (26.30 ±3.75), while patient without statin-associated muscle symptom group had the mean rating of (29.33 ±3.69), and the control group had the highest mean of (30.14 ±3.57). 
Conclusion: There is a positive relationship between vitamin D deficiency and statin-associated muscle symptoms. Vitamin D status may play an important role in diagnosis and management of SAMS. Further studies are needed to evaluate the relationship between vitamin D and SAMS.