Caroli-Bosc F X, Le Gall P, Pugliese P, Delabre B, Caroli-Bosc C, Demarquay J F, Delmont J P, Rampal P, Montet J C
Federation of Digestive Diseases, Archet II Hospital, University of Nice-Sophia, Antipolis, France.
Dig Dis Sci. 2001 Mar;46(3):540-4. doi: 10.1023/a:1005643014395.
Fibrate derivatives and HMG-CoA reductase inhibitors modify homeostasis of cholesterol. The aim of this study was to assess in an unselected population whether these hypolipidemic drugs are risk factors for cholelithiasis or, conversely, are protective agents. Both sexes, all socioeconomic categories, pregnant women, and cholecystectomized subjects were included. Clinical data collection and gallbladder ultrasonography were both carried out in a double-blind fashion. Fibrate derivatives were predominantly fenofibrate, HMG-CoA reductase inhibitors were simvastatin and pravastatin. On univariate analysis, age (>50 years), sex, and use of fibrates were found to be significantly related to the presence of cholelithiasis. Age, sex, and fibrate treatment remained independently correlated with the presence of gallstones on multivariate analysis. With fibrates, the relative risk for lithiasis was 1.7 (P = 0.04). The HMG-CoA reductase inhibitors were not associated with a protective effect on univariate analysis. Of the lipid-lowering drugs, only fibrate derivatives were found to increase the risk of gallstone formation.
贝特类衍生物和HMG-CoA还原酶抑制剂可改变胆固醇的稳态。本研究的目的是在一个未经过筛选的人群中评估这些降血脂药物是否为胆石症的危险因素，或者相反，是否为保护剂。研究纳入了所有性别、所有社会经济阶层、孕妇以及胆囊切除术后的受试者。临床数据收集和胆囊超声检查均采用双盲方式进行。贝特类衍生物主要为非诺贝特，HMG-CoA还原酶抑制剂为辛伐他汀和普伐他汀。单因素分析发现，年龄（>50岁）、性别和贝特类药物的使用与胆石症的存在显著相关。多因素分析显示，年龄、性别和贝特类药物治疗与胆结石的存在仍独立相关。使用贝特类药物时，患结石的相对风险为1.7（P = 0.04）。单因素分析中，HMG-CoA还原酶抑制剂未显示出保护作用。在降血脂药物中，仅发现贝特类衍生物会增加胆结石形成的风险。
