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(Ivanhoe Newswire) -- Taking cholesterol-lowering statin drugs for more than a year is associated with a reduced risk of developing gallstones that require surgery.
Gallstone disease is a leading cause of gastrointestinal tract illness and inpatient admission in western countries and represents a serious burden for health care systems. In developed countries, approximately 10 to 20 percent of white adults have gallstones More than 700,000 cholecystectomies (gallbladder removal) are performed annually in the United States.
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Gallstones are classified as either cholesterol stones or pigment stones, with cholesterol stones formed on the basis of cholesterol-supersaturated bile. "Statins decrease hepatic [liver] cholesterol biosynthesis and may therefore lower the risk of cholesterol gallstones by reducing the cholesterol concentration in the bile, the authors were quoted as saying. Data on this association in humans are scarce."
Michael Bodmer, M.D., M.Sc., of University Hospital, Basel, Switzerland, and colleagues conducted a large long-term observational study to examine the association between statin use and the risk of gallstone disease followed by cholecystectomy. The study included data gathered between 1994 and 2008 from the UK-based General Practice Research Database. A total of 27,035 patients with cholecystectomy and 106,531 controls were identified, including 2,396 patients and 8,868 controls who used statins.
"This large observational study provides evidence that patients with long-term statin use have a reduced risk of gallstone disease followed by cholecystectomy compared with patients without statin use, according to the authors. However, the odds ratio was not decreased for patients with short-term statin use but started to decrease after five prescriptions, reflecting approximately one to one-and-a-half years of treatment. The risk estimate was consistent across age and sex groups. Adjustment for important risk factors for gallstone disease did not materially alter the results."
The authors add that the observed risk reduction suggests a class effect for all statins, and a tendency toward a lower risk of gallstone disease for high-dose statin use compared with low-dose. A substantially increased gallstone risk with cholecystectomy was found for patients with high body mass indexes and for patients with estrogen use. The researchers concluded, "Our findings may be of clinical relevance given that gallstone disease represents a major burden for health care systems."
SOURCE: Journal of the American Medical Association (JAMA), November 11, 2009.
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