Dietary Habits and Musculoskeletal Pain in Statin and Red Yeast Rice Users: A Pilot Study.

Anna Raguzzini,Maura Palmery,Ilaria Peluso,Mohamed M Abdel-Daim,Elisabetta Toti

doi:10.3390/ejihpe11040085

Abstract

(1) Background: Diet and statins are commonly used to treat high cholesterol (CHOL) levels. (2) Aim: To compare adherence to Mediterranean diet (Med-D), orthorexia nervosa (ON), and musculoskeletal pain in individuals in treatment with statins metabolized by CYP3A4, not metabolized by CYP3A4 or red yeast rice (RYR, containing monacolin K: MON-K). (3) Methods: starting from 80 individuals, after the exclusion of those with other causes of possible pain, 56 individuals were selected and divided into three groups according to the type of statin (CYP3A4, NO-CYP3A4 and MON-K). Adherence to the Med-D was evaluated with the MEDScore and a sub-score was calculated for fruit and vegetables consumption (MEDScore-FV). ON and musculoskeletal pain were assessed with the ORTO-15 and with the Nordic Musculoskeletal questionnaires, respectively. A retrospective analysis of CHOL decrease after treatment was conducted. (4) Results: CHOL levels were lower in CYP3A4 and NO-CYP3A4 after treatment (182.4 ± 6.3 and 177.0 ± 7.8 mg/dL, respectively), compared with MON-K (204.2 ± 7.1 mg/dL, p < 0.05). MON-K and CYP3A4 groups had a high prevalence of reported knee pain (33.3% and 18.8%, respectively) than NO-CYP3A4 group (0%, p < 0.05). A high percentage of individuals in MON-K take supplements and nutraceuticals (87.5%), whereas MEDScore-FV was higher in CYP3A4 (9.4 ± 0.2) compared to NO-CYP3A4 (7.6 ± 0.5, p < 0.05). (5) Conclusions: This study suggests that individuals receiving treatment with statins and RYR should be monitored from the perspective of plant foods’ consumption and nutraceutical use, to prevent musculoskeletal pain.

Highlights

The additive cholesterol (CHOL)-lowering effects of statins’ treatment and Mediterranean diet (Med-D), rich in fruits, vegetables, monounsaturated and omega 3 fatty acids, are known since 2002 [1]
There were no statistically significant differences by gender and approximately two-thirds of the subjects were women in the group CYP3A4 and MON-K, while in the NO-CYP3A4 users were close to one-third
In line with the recommendation of other authors [15], this pilot study suggested that individuals receiving treatment with statins and red yeast rice (RYR) should be monitored from the perspective of plant foods’ consumption and the use of nutraceuticals that can reduce pain or interfere with statins’ pharmacokinetic, to prevent musculoskeletal pain

Summary

Introduction

The additive cholesterol (CHOL)-lowering effects of statins’ treatment and Mediterranean diet (Med-D), rich in fruits, vegetables, monounsaturated and omega 3 fatty acids, are known since 2002 [1]. Med-D in combination with red yeast rice (RYR) reduced low-density lipoproteins (LDL) in individuals with statin intolerance [4]. RYR, obtained by the traditional fermentation of cooked rice kernels with a Monascaceae mold, Monascus purpureus [5], by solid-state culture method [6] or by liquid-state culture method [6], contains monacolin K, a weak reversible inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, the rate-limiting enzyme of the mevalonate pathway of cholesterol synthesis [7]. Citrinin (CIT), a nephrotoxic and hepatotoxic mycotoxin, is produced by Monascus spp., it has been reported that dietary supplements contained.

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