Serum Cholesterol Differences Between Statin Users Who Take Dietary Supplements and Those Who Do Not: NHANES 2013–2018

Background: Cardiovascular disease (CVD) is the leading cause of mortality in the United States and statins are the most commonly prescribed medication. It is important to understand the potential impact supplements may have when taken in combination with statins on serum lipid outcomes. Objectives: To evaluate the differences in the concentrations of cholesterol, triacylglycerol (TAG), and HbA1c between adults who use statins alone and those who combine statins and dietary supplements. Methods: A cross-sectional analysis using data from US adults aged ≥20 years who participated in the NHANES (2013–2018). The serum concentrations of lipids and the HbA1c levels were compared using independent sample t-tests. All analyses were adjusted for the complex survey design and used appropriate sample weights. Results: Of 16,327 participants included in this analysis, 13% reported the use of statins alone, and 8.8% used statins and dietary supplements. Statin users who used dietary supplements tended to be women (50.5%), aged 65.8 ± 0.4 years, and were more likely to be White (77.4%). Participants who used statins in combination with dietary supplements were less likely to have higher levels of total cholesterol (5.1% ± 1.4% vs. 15.6% ± 2.7%, P < 0.001), HbA1c (6.0% ± 0.1% vs. 6.3% ± 0.1%, P < 0.05), and HDL cholesterol (50 ± 1.3 vs. 47 ± 0.8 mg/dL, P < 0.05) than those who used statins alone. No significant differences were identified between the two groups for LDL cholesterol and TAG concentrations. Conclusions: Statin users who coingested dietary supplements were less likely to have high levels of total cholesterol and HbA1c and greater HDL levels than statin users who did not take dietary supplements. Dietary intake, lifestyle choices, and other confounders may have influenced the observed outcome differences for those who took dietary supplements with statins and those who did not.