| Objective To assess the efficacy of statins on the makers of bone formation and bone mineral density (BMD) by collecting data from 24 randomized controlled trials. Methods The randomized controlled trials (RCTs) of statin therapy for osteoporosis patients were searched in databases of PubMed, Web of Science, CNKI, Wanfang, the Cochrane Library, and CBM from establishment of the database to November 2019. Meta-analysis was performed using RevMan5.3 and Stata15.1 software. Results Twenty-four trials were involved, including 852 patients in statin group and 798 patients in control group. The results showed that statins were associated with improved levels of osteocalcin (OC, SMD=0.22, 95% CI: 0.06-0.37, I2=0%, P=0.006), bone-specific alkaline phosphatase (BALP, SMD= 0.32, 95% CI: 0.15-0.49, P=0.0002, I2=35%), and osteoprotegerin (OPG, SMD 0.80, 95% CI: 0.14-1.45，P=0.02，I2=62%). Furthermore, statins increased BMD at the lumbar spine (SMD=0.35, 95% CI: 0.14-0.56, P=0.001, I2=59%), the femoral neck (SMD=0.32, 95% CI:0.03-0.61, P=0.03, I2=75%), the femoral intertrochanter (SMD=0.46, 95% CI 0.13-0.78, P=0.006，I2=59%), and the Ward’s triangle (SMD=0.36, 95% CI: 0.01-0.71, P=0.04, I2=77%). However, there was no positive effect on the level of procollagen type I N-terminal propeptide (PINP) and BMD at the total hip. Conclusion Our meta-analysis indicates that statin treatment may be associated with improved levels of OC, BALP, and increased BMD at the lumbar spine and the femurs. Statins have huge potential for the treatment of osteoporosis. Due to the small number and small sample size of included documents, more large sample size of high quality randomized controlled trails are needed to provide basis for this conclusion. |