Evaluation of Muscle Performance with Isokinetic Test in Patients Using Atorvastatin

Abstract

Objective: Statins are widely used to lower LDL-cholesterol levels. Two of the most important side effects are hepatotoxicity and myopathy. Myopathy is rare and characterized by widespread muscle pain, fatigue, and increased serum creatine phosphokinase levels. In this study, we aimed to show if isokinetic muscle strength is affected in patients on statin therapy. Material and Methods: In this study, we evaluated the visual pain score, sense of weakness, serum creatine phosphokinase levels, and the power of knee muscles by using an isokinetic test that enables the quantitative and objective measurement of the performance of the musculoskeletal system before and after treatment of 26 patients who used 20 mg/day atorvastatin for 3 months. Results: Two patients had myalgia after treatment, and asymptomatic elevation of serum creatine phosphokinase was observed in one patient. Before and after the treatment, there was no statistically significant difference in visual pain scores and serum creatine phosphokinase levels. After treatment, flexion and extension peak torque values at 60 degrees/s velocity were significantly reduced compared to the values before treatment. The effect of statins on mitochondrial phosphorylation and type 1 and type 2a fibers, which mainly use the oxidative path in the production of energy, may explain these results. Conclusion: In conclusion, in this study, 20 mg/day atorvastatin for 3 months caused a decrease in isokinetic muscle strength without causing an increase in serum creatine phosphokinase levels and clinically significant myopathy.