Statin Use and the Risk of Cholecystectomy in Women

Tsai, Chung–Jyi; Leitzmann, Michael F.; Willett, Walter C.; Giovannucci, Edward L.

doi:10.1053/j.gastro.2009.01.042

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Volume 136, Issue 5 , Pages 1593-1600, May 2009

Statin Use and the Risk of Cholecystectomy in Women

Chung–Jyi Tsai
- Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, Lexington, Kentucky
- Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
- Correspondence Address correspondence to: Chung–Jyi Tsai, MD, ScD, Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, 800 Rose Street, Lexington, Kentucky 40536-0298. fax: (859) 257-8860
Michael F. Leitzmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
Walter C. Willett
- Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts
Edward L. Giovannucci
- Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts

Received 10 November 2008; accepted 22 January 2009. published online 27 January 2009.

Background & Aims

Statins can reduce biliary cholesterol secretion independently of their ability to inhibit cholesterol synthesis. Statins also prevent the formation of gallstones in animal studies, although the effect of statins on human gallstone disease has been controversial.

Methods

We examined the relationship between the use of statins and the risk of cholecystectomy in a cohort of US women. As part of the prospective Nurses' Health Study, participants biennially reported their history of gallstone disease and whether they had undergone cholecystectomy. Women also reported lifetime use of statins retrospectively in 2000. We conducted a retrospective analysis of statin using data collected in 2000, to define use from 1994 forward, and a prospective analysis for general lipid-lowering drugs from 1994 to 2004.

Results

In the statin analysis we ascertained 2479 cases of cholecystectomy during 305,197 person-years of follow-up evaluation. The multivariate relative risk for current statin users, compared with nonusers, was 0.82 (95% confidence interval, 0.70–0.96). In the analysis of general cholesterol-lowering drugs, we ascertained 3420 cases of cholecystectomy during 511,411 person-years of follow-up evaluation. Compared with nonusers, the multivariate relative risk for current users of general cholesterol-lowering drugs, mostly statins in this cohort, was 0.88 (95% confidence interval, 0.79–0.98).