Division of Gastroenterology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Gastroenterology, VA North Texas Health Care System, Dallas, TX, USA.
Clin Drug Investig. 2018 Feb;38(2):135-146. doi: 10.1007/s40261-017-0589-x.
Statins are commonly used medications. Whereas some observational studies suggested an association of statin use with Barrett's esophagus and some upper gastrointestinal symptoms, there is a dearth of data on the association of statins and common esophageal conditions such as gastroesophageal reflux disease and esophagitis. The aim of this study is to examine the association of statins with esophageal conditions.
This is a retrospective cohort study using regional military healthcare data (1 October, 2003 to 1 March, 2012). The primary analyses evaluated the odds of: esophagitis; symptoms of esophagitis; gastroesophageal reflux disease/dyspepsia; and esophageal complications of gastroesophageal reflux disease in four propensity score-matched cohorts of statin users and non-users (propensity score-overall, propensity score-healthy, propensity score-women, and propensity score-men cohorts). Secondary and sensitivity analyses were performed.
In the propensity score-overall cohort (n = 12,684), statin users were more likely to be diagnosed with esophagitis (odds ratio 1.11, 95% confidence interval 1.01-1.22) and gastroesophageal reflux disease/dyspepsia (odds ratio 1.18, 95% confidence interval 1.10-1.27) compared with non-users. Similar findings were seen in the propensity score-healthy cohort and in the propensity score-men cohort. In the propensity score-women cohort, the odds of esophagitis was higher among statin users compared with non-users (odds ratio 1.16, 95% confidence interval 1.02-1.32) but other outcomes were not different. In sensitivity analyses, which excluded patients with obesity, statin use was not associated with an increased odds ratio of gastroesophageal reflux disease/dyspepsia.
Statin therapy was associated with higher odds of being diagnosed with esophagitis and gastroesophageal reflux disease/dyspepsia. Further study is warranted to elucidate the potential role of statins in these commonly diagnosed esophageal conditions.
他汀类药物是常用的药物。虽然一些观察性研究表明他汀类药物的使用与巴雷特食管和一些上消化道症状有关，但关于他汀类药物与常见食管疾病（如胃食管反流病和食管炎）的关联数据却很少。本研究旨在探讨他汀类药物与食管疾病的关系。
这是一项使用地区性军事医疗保健数据（2003 年 10 月 1 日至 2012 年 3 月 1 日）的回顾性队列研究。主要分析评估了四组倾向评分匹配的他汀类药物使用者和非使用者中食管炎、食管炎症状、胃食管反流病/消化不良和胃食管反流病食管并发症的可能性：总体倾向评分、健康倾向评分、女性倾向评分和男性倾向评分队列。进行了二次和敏感性分析。
在总体倾向评分队列（n=12684）中，与非使用者相比，他汀类药物使用者更有可能被诊断为食管炎（比值比 1.11，95%置信区间 1.01-1.22）和胃食管反流病/消化不良（比值比 1.18，95%置信区间 1.10-1.27）。在健康倾向评分队列和男性倾向评分队列中也观察到了类似的发现。在女性倾向评分队列中，与非使用者相比，他汀类药物使用者的食管炎发生率更高（比值比 1.16，95%置信区间 1.02-1.32），但其他结果无差异。在排除肥胖患者的敏感性分析中，他汀类药物的使用与胃食管反流病/消化不良的比值比增加无关。
他汀类药物治疗与更高的食管炎和胃食管反流病/消化不良诊断几率相关。需要进一步研究阐明他汀类药物在这些常见诊断食管疾病中的潜在作用。
