מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Postmenopausal women who receive hormone replacement therapy (HRT) are more likely to undergo biliary tract surgery than older women who do not receive HRT, according to a report published in the October 2nd issue of the Annals of Internal Medicine.
While some observational studies have suggested a link between estrogen use and gallbladder disease, others have not, the authors state. Few studies have examined the effect of combined estrogen and progestin therapy on the risk of biliary tract disease.
Dr. Joel A. Simon, from the San Francisco Veterans Affairs Medical Center, and colleagues studied 2253 postmenopausal women with coronary artery disease who participated in the Heart and Estrogen/progestin Replacement Study (HERS) and had a gallbladder at baseline. The women were randomized to receive a 0.625 mg estrogen/2.5 mg progestin tablet once daily or identical placebo.
During a mean followup period of 4.1 years, 7% of women underwent biliary tract surgery, the authors note. Women who received HRT were 38% more likely to undergo the surgery than women who received placebo (p = 0.05). However, after adjustment for baseline and in-study statin use, the association was not statistically significant (p = 0.09).
Increased body mass index, fibric acid use, and history of nonsurgical gallbladder disease were tied to an increased risk for biliary tract surgery, whereas statin use was linked to a decreased risk, the researchers state.
"I think it is fairly clear that there is a link between HRT use and gallbladder disease," Dr. Simon told Reuters Health. "However, the risk identified in the current study wasn't as great as some identified in other studies," he noted. "In a study of men, HRT use was associated with a 65% increased risk of gallbladder disease," he said.
"In my opinion, the most exciting finding was that statin use was associated with a 45% reduction in risk of gallbladder disease," Dr. Simon pointed out. "The correlation was very robust and it really didn't change after adjusting for other factors."
"HRT use is a risk factor for gallbladder disease, but compared to other risk factors, its influence is modest," Dr. Simon concluded.
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