Background and Objective: Atorvastatin (Ator) is widely used to lower blood cholesterol but often causes muscle-related side
effects. Alfacalcidol (Alf), a vitamin D analog, has shown positive effects on muscle health. This study aimed to elucidate the
possible protective role of Alf on gastrocnemius muscle damage after Ator intake in male albino rats.
Materials and Methods: Thirty-six adult male albino rats were randomly divided into three groups: Group I (Control; n = 12),
Group II (Ator-treated; n = 12), and Group III (Ator and Alf-treated; n = 12). Group II received Ator (10 mg/kg/day) in 0.5 ml
distilled water containing 2 mg Ator. Group III received Alf (1 μg/kg/day) concomitantly with Ator, prepared by crushing and
dissolving tablets in 0.5 ml distilled water. All drugs were administered orally for 4 weeks. Twenty-four hours after the last dose,
rats were sacrificed under anesthesia by intraperitoneal injection of phenobarbital (80 mg/kg). A biochemical study for creatine
phosphokinase (CPK) was performed. Muscle specimens were dissected and examined using light microscopy (Hematoxylin
and Eosin, Masson's trichrome, and PAS stains) and electron microscopy. Morphometric and statistical analyses were conducted.
Results: Group II showed histological changes indicating myopathy and degenerative changes, which regressed in Group III.
The mean CPK values significantly increased in Group II compared to the control and Group III.
Conclusions: Alfacalcidol demonstrated a definitive protective effect against Ator-induced skeletal muscle damage, confirmed
through biochemical and histological analyses. Alf can be recommended for hypercholesterolemic patients on Statins, particularly
those at risk of vitamin D deficiency.