Literature DB >> 23509128

Menopausal hormone therapy and risk of cholecystectomy: a prospective study based on the French E3N cohort.

Antoine Racine1, Anne Bijon, Agnès Fournier, Sylvie Mesrine, Françoise Clavel-Chapelon, Franck Carbonnel, Marie-Christine Boutron-Ruault.   

Abstract

BACKGROUND: Studies in the United States and the United Kingdom have reported an increased risk of cholecystectomy among women exposed to menopausal hormone therapy, but with substantial heterogeneity between types of hormone treatments. We evaluated the risk of cholecystectomy associated with different regimens of menopausal hormone therapy in a large prospective cohort study.
METHODS: Between 1992 and 2008, 70 928 menopausal women from the French E3N study cohort were sent questionnaires assessing their use of menopausal hormone therapy, medical history and lifestyle characteristics. The primary outcome was cholecystectomy. We analyzed the risk of cholecystectomy associated with use of menopausal hormone therapy using Cox proportional models, with age as time-scale.
RESULTS: During follow-up, 45 984 (64.8%) of the participants were exposed to menopausal hormone therapy, and 2819 cholecystectomies were recorded. The use of menopausal hormone therapy was associated with an increased risk of cholecystectomy (adjusted hazard ratio [HR] 1.10, 95% confidence interval [CI] 1.01-1.20) compared with women who were not exposed to menopausal hormone therapy. The association was restricted to unopposed oral estrogen therapy (adjusted HR 1.38, 95% CI 1.14-1.67). Over 5 years, about 1 cholecystectomy in excess would be expected in every 150 women using oral estrogen therapy without progestogens, compared with women not exposed to menopausal hormone therapy.
INTERPRETATION: The risk of cholecystectomy was increased among women exposed to oral estrogen menopausal hormone therapy, especially oral regimens without a progestagen. Complicated gallstone disease should be added to the list of potential adverse events to be considered when balancing the benefits and risks associated with menopausal hormone therapy.

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Year:  2013        PMID: 23509128      PMCID: PMC3626807          DOI: 10.1503/cmaj.121490

Source DB:  PubMed          Journal:  CMAJ        ISSN: 0820-3946            Impact factor:   8.262


  30 in total

Review 1.  Estrogen replacement therapy and gallbladder disease in postmenopausal women.

Authors:  M L Uhler; J W Marks; H L Judd
Journal:  Menopause       Date:  2000 May-Jun       Impact factor: 2.953

2.  Gallstone disease is associated with increased mortality in the United States.

Authors:  Constance E Ruhl; James E Everhart
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4.  Menopausal hormone therapy and new-onset diabetes in the French Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) cohort.

Authors:  B de Lauzon-Guillain; A Fournier; A Fabre; N Simon; S Mesrine; M-C Boutron-Ruault; B Balkau; F Clavel-Chapelon
Journal:  Diabetologia       Date:  2009-07-23       Impact factor: 10.122

5.  Postmenopausal hormone therapy and asthma onset in the E3N cohort.

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6.  Loci from a genome-wide analysis of bilirubin levels are associated with gallstone risk and composition.

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Review 10.  New insights into the molecular mechanisms underlying effects of estrogen on cholesterol gallstone formation.

Authors:  Helen H Wang; Min Liu; Deborah J Clegg; Piero Portincasa; David Q-H Wang
Journal:  Biochim Biophys Acta       Date:  2009-07-06
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2.  Risk of breast cancer after stopping menopausal hormone therapy in the E3N cohort.

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3.  Diet and Risk of Cholecystectomy: A Prospective Study Based on the French E3N Cohort.

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4.  Menopausal hormone therapy and risk of biliary tract cancers.

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5.  Plant-Based Diet, Cholesterol, and Risk of Gallstone Disease: A Prospective Study.

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6.  Development of a novel model of cholecystectomy in subsequently ovariectomized mice and characterization of metabolic and gastrointestinal phenotypes: a pilot study.

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Review 7.  Risk Factors for Cholelithiasis.

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9.  Risk factors for requiring cholecystectomy for gallstone disease in a prospective population-based cohort study.

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