Statin-Associated Myopathy with Normal Creatine Kinase Levels
Authors: Emil Toma, Maude Loignon
Journal: Annals of Internal Medicine (2003)

Letters17 June 2003Statin-Associated Myopathy with Normal Creatine Kinase LevelsEmil Toma, MD, DSc, FRCP(C) and Maude Loignon, BScEmil Toma, MD, DSc, FRCP(C)Htel-Dieu Hospital; Montreal, Quebec H2W 1T8, Canada (Toma, Loignon) and Maude Loignon, BScHtel-Dieu Hospital; Montreal, Quebec H2W 1T8, Canada (Toma, Loignon)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-12-200306170-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Phillips and colleagues (1) nicely documented biopsy-confirmed myopathy in patients with normal creatine kinase levels in association with statin therapy. As they mentioned in their discussion, similar features are reported for coenzyme Q10 deficiency. It is known that 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibition by statins influences not only the cholesterol synthesis but also that of proteins such as farnesylated and geranylgeranylated proteins and ubiquinones such as coenzyme Q10. Similar to cholesterol synthesis, the primary regulation of coenzyme Q10 biosynthesis is the HMG-CoA reductase reaction, providing its isoprenyl side chain deriving from mevalonate. Decreased plasma levels of ...References1. Phillips PS, Haas RH, Bannykh S, Hathaway S, Gray NL, Kimura BJ, . Statin-associated myopathy with normal creatine kinase levels. Ann Intern Med. 2002;137:581-5. [PMID: 12353945] LinkGoogle Scholar2. Watts GF, Castelluccio C, Rice-Evans C, Taub NA, Baum H, Quinn PJ. Plasma coenzyme Q (ubiquinone) concentrations in patients treated with simvastatin. J Clin Pathol. 1993;46:1055-7. [PMID: 8254097] CrossrefMedlineGoogle Scholar3. Mortensen SA, Leth A, Agner E, Rohde M. Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med. 1997;18 Suppl S137-44. [PMID: 9266515] CrossrefMedlineGoogle Scholar4. Bargossi AM, Grossi G, Fiorella PL, Gaddi A, Di Giulio R, Battino M. Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med. 1994;15 Suppl s187-93. [PMID: 7752830] CrossrefMedlineGoogle Scholar5. Bhuiyan J, Seccombe DW. The effects of 3-hydroxy-3-methylglutaryl-CoA reductase inhibition on tissue levels of carnitine and carnitine acyltransferase activity in the rabbit. Lipids. 1996;31:867-70. [PMID: 8869889] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Htel-Dieu Hospital; Montreal, Quebec H2W 1T8, Canada (Toma, Loignon) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoStatin-Associated Myopathy with Normal Creatine Kinase Levels Paul S. Phillips , Richard H. Haas , Sergei Bannykh , Stephanie Hathaway , Nancy L. Gray , Bruce J. Kimura , Georgirene D. Vladutiu , John D.F. England , and Statin-Associated Myopathy with Normal Creatine Kinase Levels Louis Evan Teichholz Statin-Associated Myopathy with Normal Creatine Kinase Levels Paul S. Phillips and Richard H. Haas Statin-Associated Myopathy with Normal Creatine Kinase Levels Mark H. Hyman Statin-Associated Myopathy with Normal Creatine Kinase Levels Josh Torgovnick and Edward Arsura Metrics Cited byEffects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled TrialsExertion-induced rhabdomyolysis in a patient on statin therapy 17 June 2003Volume 138, Issue 12Page: 1007-1008KeywordsBiosynthesisBlood plasmaCholesterolClinical trialsCoenzymesCreatine kinasePathogensProtein synthesisRabbitsStatins ePublished: 17 June 2003 Issue Published: 17 June 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...