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Statin use and risk of gallstone disease followed by cholecystectomy.

Abstract

CONTEXT

Gallstone disease is a leading cause of morbidity in western countries and carries a high economic burden. Statins decrease hepatic cholesterol biosynthesis and may therefore lower the risk of cholesterol gallstones by reducing the cholesterol concentration in the bile. Data on this association in humans are scarce.

OBJECTIVE

To study the association between the use of statins, fibrates, or other lipid-lowering agents and the risk of incident gallstone disease followed by cholecystectomy.

DESIGN, SETTING, AND PARTICIPANTS

Case-control analysis using the UK-based General Practice Research Database. Incident patients between 1994 and 2008 and 4 controls per each patient were identified and matched on age, sex, general practice, calendar time, and years of history in the database. The study population was 76% women and the mean (SD) age was 53.4 (15.0) years at the index date. Conditional logistic regression was used to estimate the odds ratio (OR) of developing gallstones followed by cholecystectomy in relation to exposure to lipid-lowering agents, stratified by exposure timing and duration. The ORs and 95% confidence intervals (CIs) were adjusted for smoking, body mass index, ischemic heart disease, stroke, and estrogen use.

MAIN OUTCOME MEASURE

The adjusted OR (AOR) for developing gallstone disease followed by cholecystectomy in relation to exposure to lipid-lowering agents.

RESULTS

A total of 27,035 patients with cholecystectomy and 106,531 matched controls were identified, including 2396 patients and 8868 controls who had statin use. Compared with nonuse, current statin use (last prescription recorded within 90 days before the first-time diagnosis of the disease) was 1.0% for patients and 0.8% for controls (AOR, 1.10; 95% CI, 0.95-1.27) for 1 to 4 prescriptions; 2.6% vs 2.4% (AOR, 0.85; 95% CI, 0.77-0.93) for 5 to 19 prescriptions, and 3.2% vs 3.7% (AOR, 0.64; 95% CI, 0.59-0.70) for 20 or more prescriptions. The AORs for current use of statins defined as 20 or more prescriptions were similar (around 0.6) across age, sex, and body mass index categories, and across the statin class.

CONCLUSION

Long-term use of statins was associated with a decreased risk of gallstones followed by cholecystectomy.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Clinical Pharmacology and Toxicology, University Hospital, Basel, Switzerland.

    , , ,

    Source

    JAMA 302:18 2009 Nov 11 pg 2001-7

    MeSH

    Adult
    Case-Control Studies
    Cholecystectomy
    Female
    Gallstones
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Hypolipidemic Agents
    Logistic Models
    Male
    Middle Aged
    Risk
    Time Factors

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    19903921

    Citation

    Bodmer, Michael, et al. "Statin Use and Risk of Gallstone Disease Followed By Cholecystectomy." JAMA, vol. 302, no. 18, 2009, pp. 2001-7.
    Bodmer M, Brauchli YB, Krähenbühl S, et al. Statin use and risk of gallstone disease followed by cholecystectomy. JAMA. 2009;302(18):2001-7.
    Bodmer, M., Brauchli, Y. B., Krähenbühl, S., Jick, S. S., & Meier, C. R. (2009). Statin use and risk of gallstone disease followed by cholecystectomy. JAMA, 302(18), pp. 2001-7. doi:10.1001/jama.2009.1601.
    Bodmer M, et al. Statin Use and Risk of Gallstone Disease Followed By Cholecystectomy. JAMA. 2009 Nov 11;302(18):2001-7. PubMed PMID: 19903921.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Statin use and risk of gallstone disease followed by cholecystectomy. AU - Bodmer,Michael, AU - Brauchli,Yolanda B, AU - Krähenbühl,Stephan, AU - Jick,Susan S, AU - Meier,Christoph R, PY - 2009/11/12/entrez PY - 2009/11/12/pubmed PY - 2009/12/16/medline SP - 2001 EP - 7 JF - JAMA JO - JAMA VL - 302 IS - 18 N2 - CONTEXT: Gallstone disease is a leading cause of morbidity in western countries and carries a high economic burden. Statins decrease hepatic cholesterol biosynthesis and may therefore lower the risk of cholesterol gallstones by reducing the cholesterol concentration in the bile. Data on this association in humans are scarce. OBJECTIVE: To study the association between the use of statins, fibrates, or other lipid-lowering agents and the risk of incident gallstone disease followed by cholecystectomy. DESIGN, SETTING, AND PARTICIPANTS: Case-control analysis using the UK-based General Practice Research Database. Incident patients between 1994 and 2008 and 4 controls per each patient were identified and matched on age, sex, general practice, calendar time, and years of history in the database. The study population was 76% women and the mean (SD) age was 53.4 (15.0) years at the index date. Conditional logistic regression was used to estimate the odds ratio (OR) of developing gallstones followed by cholecystectomy in relation to exposure to lipid-lowering agents, stratified by exposure timing and duration. The ORs and 95% confidence intervals (CIs) were adjusted for smoking, body mass index, ischemic heart disease, stroke, and estrogen use. MAIN OUTCOME MEASURE: The adjusted OR (AOR) for developing gallstone disease followed by cholecystectomy in relation to exposure to lipid-lowering agents. RESULTS: A total of 27,035 patients with cholecystectomy and 106,531 matched controls were identified, including 2396 patients and 8868 controls who had statin use. Compared with nonuse, current statin use (last prescription recorded within 90 days before the first-time diagnosis of the disease) was 1.0% for patients and 0.8% for controls (AOR, 1.10; 95% CI, 0.95-1.27) for 1 to 4 prescriptions; 2.6% vs 2.4% (AOR, 0.85; 95% CI, 0.77-0.93) for 5 to 19 prescriptions, and 3.2% vs 3.7% (AOR, 0.64; 95% CI, 0.59-0.70) for 20 or more prescriptions. The AORs for current use of statins defined as 20 or more prescriptions were similar (around 0.6) across age, sex, and body mass index categories, and across the statin class. CONCLUSION: Long-term use of statins was associated with a decreased risk of gallstones followed by cholecystectomy. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/19903921/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2009.1601 DB - PRIME DP - Unbound Medicine ER -