Abstract
Introduction: It has been shown that dyslipidemia is related to bone mineral density and fragility. Hypolipemiant drugs as statins or fibrates seem to increase the bone mineral density and probably to protect against fractures. The question that arises in this context is whether statins or fibrates have a positive effect on bone fracture repair process and which is their behaviour in an osteoporotic context. Our objective was to study the incidence of osteoporosis, dyslipidemia and of the association of these diseases, and to compare the effect of statins and fibrates on fracture repair in experimental conditions.
Material and method: We studied the incidence of dyslipidemia and osteoporosis in the activity of a private family medicine cabinet. In the experimental part we observed from a radiographic point of view the fracture repair process of rats’ femurs. We analyzed 6 subgroups of 12 rats each: (1) ovariectomized control, (2) ovariectomized treated with statins, (3) ovariectomized treated with fibrates, (4) nonovariectomized control, (5) ) nonovariectomized treated with statins, (6) ) nonovariectomized treated with fibrates. The radiographic aspect has been objectified with a score at 2, 4, 6 and 8 weeks.
Results: From the total of 646 patients included in the study, 193 (29.87%) had dyslipidemia while osteoporosis was diagnosed at 152 (23.53%) patients. 301 (46.6%) patients presented the association of these diseases. Comparing the subgroups of the OVX group, we had the following results: subgroup 1 - 5.5 points, group 2 - 11 points and group 3 - 4.5 points. In the case of the NOVX subgroups, the scores were: subgroup 4 - 7.5 points, subgroup 5 - 10 points and subgroup 6 - 6.5 points.
Conclusions: The fact that the incidence of dyslipidemia is higher than that of osteoporosis is an argument for the necessity of choosing a hypolipemiant treatment that has, at the same time, a protective effect on bone. Hypolipemiant treatment influences the fracture repair process. The positive effect of statins on this process is more important on the ovariectomized group, in contrast with fibrates which have an accentuated effect on the nonovariectomized group and this suggests an interference between hypolipemiant treatment and estrogens level. However, the treatment with fibrates delays the fracture repair, groups (3) and (6) scores being inferior to those of the control group. We sustain the helping effect of statins treatment on fracture repair process.