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They can also exert adverse effects, mostly affecting skeletal muscle, ranging from mild myalgia to rhabdomyolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Based on a PubMed search until December 2014, this review summarizes studies on statin effects on muscle mitochondrial morphology and function in the context of myopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Possible mechanisms of statin\u2010induced myopathy include lower cholesterol synthesis and production of prenylated proteins, reduced dolichols and increased atrogin\u20101 expression. Statin\u2010treated patients frequently feature decreased muscle coenzyme\n                      <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>\n                      10 (\n                      <jats:styled-content style=\"fixed-case\">CoQ<\/jats:styled-content>\n                      10) contents, suggesting that statins might impair mitochondrial function. In cell cultures, statins diminish muscle oxygen consumption, promote mitochondrial permeability transient pore opening and generate apoptotic proteins. Animal models confirm the statin\u2010induced decrease in muscle\n                      <jats:styled-content style=\"fixed-case\">CoQ<\/jats:styled-content>\n                      10, but reveal no changes in mitochondrial enzyme activities. Human studies yield contradictory results, with decreased\n                      <jats:styled-content style=\"fixed-case\">CoQ<\/jats:styled-content>\n                      10, elevated lipids, decreased enzyme activities in muscle and impaired maximal oxygen uptake in several but not all studies. Some patients are susceptible to statin\u2010induced myopathy due to variations in genes encoding proteins involved in statin uptake and biotransformation such as the solute carrier organic anion transporter family member 1B1 (\n                      <jats:styled-content style=\"fixed-case\">SLCO<\/jats:styled-content>\n                      1B1) or cytochrome P450 (\n                      <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>\n                      2D6,\n                      <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>\n                      3A4,\n                      <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>\n                      3A5). Carriers for carnitine palmitoyltransferase\n                      <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>\n                      deficiency and McArdle disease also present with higher prevalence of statin\u2010induced myopathy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the widespread use of statins, the pathogenesis of statin\u2010induced myopathy remains unclear, requiring prospective randomized controlled trials with intensive phenotyping also for identifying strategies for its risk assessment, prevention and treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.12461","type":"journal-article","created":{"date-parts":[[2015,5,19]],"date-time":"2015-05-19T05:47:20Z","timestamp":1432014440000},"page":"745-754","source":"Crossref","is-referenced-by-count":131,"title":["The role of mitochondria in statin\u2010induced myopathy"],"prefix":"10.1111","volume":"45","author":[{"given":"Maria","family":"Apostolopoulou","sequence":"first","affiliation":[{"name":"Institute for Clinical Diabetology German Diabetes Center Leibniz Institute for Diabetes Research Heinrich Heine University D\u00fcsseldorf Germany"},{"name":"German Center for Diabetes Research (DZD e.V.) 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