Background. Besides lipid-lowering effect of statins, they have been shown to have nonlipid lowering effects, such as improving bone health. An improvement in bone mineral density (BMD) has been indicated in some studies after the use of statins, in addition to an increase in 25-hydroxyvitamin D (25OHD) level. The aim of this study is to explore the association between statins and bone health taking into consideration 25OHD level and BMD. Methods. This is a randomized, cross-sectional comparative study. Subjects were divided into two groups, hypercholesterolemic participants taking simvastatin or atorvastatin as the study group and a matched control group not taking statins. All participants were assessed for serum 25OHD and BMD at lumbar spine and femoral neck. Results. A total of 114 participants were included in the study, 57 participants in each group. Results of serum 25OHD showed no significant difference between study and control groups ( ), while BMD results of lumbar spine and femoral neck showed significant difference ( and 0.03, resp.). Conclusion. Simvastatin and atorvastatin, at any dose for duration of more than one year, have no additive effect on 25OHD level but have a positive effect on the BMD. 1. Introduction Statins are a group of medications used to treat dyslipidemia. They work by competitively inhibiting HMG-CoA reductase, the enzyme involved in the conversion of HMG-CoA to mevalonate, an early rate-limiting step in the synthesis of cholesterol in the liver [1]. Besides the lipid lowering effect of statins in the primary and secondary prevention of coronary artery diseases [2] and heart failure [3], they have been shown to have nonlipid lowering effects, such as in the treatment of infections [4], Alzheimer’s disease [5], stroke [6], and rheumatoid arthritis [7]. Therefore, statins have become an area of research in the battle for management or prevention of many detrimental diseases. The most frequently used statins in Saudi Arabia are simvastatin and atorvastatin. Both medications proved to have a LDL-C lowering effect of >25% and 66%, respectively [8]. Osteoporosis is a leading public health problem and one of the most common diseases among Saudi population as it has a prevalence of 23% [9]. Osteoporosis is defined as the reduction in the strength of bone leading to an increased risk of fractures. Loss of bone tissue is associated with deterioration in skeletal microarchitecture. The World Health Organization operationally defines osteoporosis as a bone density that falls 2.5 standard deviations (SD) below the mean for young
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