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BMP signaling→bone mineral density→fracture risk reduction
Statins may reduce fracture risk by increasing bone mineral density through osteoblast-stimulating effects via the mevalonate pathway and BMP signaling. Evidence from observational studies shows reduced fracture risk in statin users, though the effect is modest and the evidence base is primarily epidemiological. This partially overlaps with the osteoporosis candidate but addresses a distinct clinical outcome.
“Studies show that statins users are at reduced risk of fracture and improved bone mineral density.”
— Statin use associated with a reduced risk of hip fracture in patients with gout. (2024)DOI“Regarding the effect of hypolipidemic medications on bone metabolism, statins may slightly increase BMD and reduce fracture risk, although the evidence is not robust, as it is for omega-3 fatty acids.”
— Bone Health in Patients with Dyslipidemias: An Underestimated Aspect. (2022)DOI“The focus of research centers mainly on simvastatin, a lipophilic statin demonstrating efficacy in preventing osteoporosis and aiding in fracture and bone defect healing.”
— Statins-Their Role in Bone Tissue Metabolism and Local Applications with Different Carriers. (2024)DOI“We explored these issues using two case studies: primary prevention of cardiovascular disease using statins and osteoporotic fracture using bisphosphonates.”
— The implications of competing risks and direct treatment disutility in cardiovascular disease and osteoporotic fracture: risk prediction and cost effectiveness analysis. (2024)DOI“Statin use in patients with type 2 diabetes has lower risk of hip fractures: A Taiwan national population-based study.”
— Statin use in patients with type 2 diabetes has lower risk of hip fractures: A Taiwan national population-based study. (2022)DOI“Letter: Statin use in patients with type 2 diabetes has lower risk of hip fractures: A Taiwan national population-based study.”
— Letter: Statin use in patients with type 2 diabetes has lower risk of hip fractures: A Taiwan national population-based study. (2023)DOI“Osteoporosis and hyperlipidemia are closely correlated and statins might be associated with a decreased risk of fracture.”
— Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors and the Risk of Fracture: A Systematic Review and Meta-analysis of Randomized Controlled Trials. (2023)DOI“During a 4-year follow-up period, the risk of major osteoporotic fractures was significantly reduced by 9% (OR, 0.91; 95% CI, 0.85-0.97) in statin users compared with that in non-users.”
— Statin Therapy and the Risk of Osteoporotic Fractures in Patients with Metabolic Syndrome: a Nested Case-Control Study. (2021)DOI“This review explores the individual and potential synergistic effects of BCP and statins on bone fracture healing.”
— β-Caryophyllene and Statins in Bone Fracture Healing - A Narrative Review. (2025)DOI“Previous studies have revealed the protective effects of statins on bone but the association of statins use with osteoporotic fractures has shown controversial results.”
— Age- and dose-dependent effect of statin use on the risk of osteoporotic fracture in older adults. (2023)DOI“The use of higher-potency statins compared to lower-potency statins was associated with a lower risk of osteoporosis, vertebral fracture, and hip fracture in patients with stroke.”
— Association of higher potency statin use with risk of osteoporosis and fractures in patients with stroke in a Korean nationwide cohort study. (2024)DOI“Letter: Statin use in patients with type 2 diabetes has lower risk of hip fractures.”
— Letter: Statin use in patients with type 2 diabetes has lower risk of hip fractures. (2023)DOI“Advantages of statin usage in preventing fractures for men over 50 in the United States: National Health and Nutrition Examination Survey.”
— Advantages of statin usage in preventing fractures for men over 50 in the United States: National Health and Nutrition Examination Survey. (2024)DOI“Several epidemiological studies have reported a relationship between statin treatment and increased bone mineral density (BMD) and reduced fracture risk, but the mechanism underlying the purported relationship is unclear.”
— The Effect of Plasma Lipids and Lipid-Lowering Interventions on Bone Mineral Density: A Mendelian Randomization Study. (2020)DOI“Statins, commonly used in treatment of dyslipidemia, could also enhance fracture healing in animal trials, especially when they were applied locally at the fracture site.”
— Molecular enhancement of fracture healing - Is there a role for Bone Morphogenetic Protein-2, parathyroid hormone, statins, or sclerostin-antibodies? (2021)DOI“This systematic review and meta-analysis evaluated the efficacy of statins in improving BMD and reducing fracture risk in postmenopausal osteoporosis.”
— Efficacy of Statins in Postmenopausal Osteoporosis: A Systematic Review and Meta-Analysis. (2025)DOI“This study aims to investigate whether statins decrease MI in hip fracture surgery and reduce mortality resulting from MI.”
— Preadmission Statin Prescription and Inpatient Myocardial Infarction in Geriatric Hip Fracture. (2021)DOI“9 Numerous observational studies have demonstrated that the use of statins is associated with lower risk of osteoporotic fractures.”
— Correspondence on 'Concomitant use of oral glucocorticoids and proton pump inhibitors and risk of osteoporotic fractures among patients with rheumatoid arthritis: a population-based cohort study'. (2021)DOI“Abstract #781083: Statins Reduce Incident Hip Fractures Among Chinese People with Type 2 Diabetes: The Effect of Cumulative Daily Defined Dose”
— Abstract #781083: Statins Reduce Incident Hip Fractures Among Chinese People with Type 2 Diabetes: The Effect of Cumulative Daily Defined Dose (2020)DOI