Abstract
Post-marketing surveillance data suggest a potential link between atorvastatin use and sarcopenia. However, further large-scale observational studies are needed to confirm this preliminary finding. This study aims to comprehensively investigate the relationship between atorvastatin exposure and sarcopenia, with the goal of providing more accurate safety and efficacy profiles to guide its clinical use. We utilized two primary datasets: the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 and the Food and Drug Administration Adverse Event Reporting System (FAERS) from 2004 to 2018. Using a multi-step analytical approach that included descriptive statistical analysis, multivariable logistic regression, and receiver operating characteristic (ROC) curve analysis, we systematically assessed the relationship between atorvastatin exposure and the incidence of sarcopenia. In the NHANES cohort analysis, after adjusting for demographic variables, lifestyle factors, and other confounders in the multivariable logistic regression model, atorvastatin use was associated with an increased risk of sarcopenia (OR = 2.21; 95% CI: 1.07-4.55; p = 0.032). An analysis of the FAERS database identified 13,625 adverse event reports related to atorvastatin, of which 5370 specifically documented myasthenia-related events. Independent analyses from both population-based epidemiological surveys and pharmacovigilance systems consistently indicate that atorvastatin use may increase the risk of sarcopenia. Based on these findings, we recommend that healthcare providers implement comprehensive risk communication strategies before prescribing atorvastatin, with particular emphasis on the need for regular musculoskeletal assessments in patients undergoing long-term statin therapy.