Korean J Intern Med.  2024 Jul;39(4):650-658. 10.3904/kjim.2024.085.

Effects of statin use on serum creatinine phosphokinase levels in normal thyroid function

• Ha J
• Lee J
• Yu J
• Park H
• Shinn J
• Lee SH
• Cho JH
• Kim HS

• KMID: 2556914
• DOI: http://doi.org/10.3904/kjim.2024.085

Abstract

Background/Aims
Statins are common lipid-lowering agents used in dyslipidemia. However, they increase serum creatinine phosphokinase (CPK) levels. Currently, there are no studies on the effect of thyroid-stimulating hormone (TSH) levels on CPK levels after statin administration. Therefore, this study aimed to investigate CPK level alterations after statin administration according to TSH quartiles in participants with euthyroidism.
Methods
This retrospective analysis included 25,047 patients with euthyroidism. CPK levels were measured before and 6 months after statin administration. Normal TSH levels were divided into four quartiles, and the CPK levels and proportions of patients with normal CPK levels after statin administration for each TSH quartile were evaluated.
Results
The baseline CPK level was significantly higher in the lowest TSH quartile (Q1) compared to the other quartiles but decreased after statin administration. Thus, the difference between the CPK levels and the other quartile groups was not significant. The proportion of patients with normal CPK levels was also significantly lowest in Q1 before statin administration; however, no significant difference was noted in the ratio among each group after statin administration. These findings were consistent with the findings of the analysis according to statin intensity.
Conclusions
In patients in the lowest TSH quartile of the normal TSH range, the CPK level decreased, and the proportion of normal CPK levels increased significantly after statin administration. However, similar changes were not observed in other TSH quartiles. Therefore, further studies are required to mechanistically confirm these conclusions.

Keyword

Hydroxymethylglutaryl-CoA reductase inhibitors; Hypothyroidism; Thyrotropin