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他汀类药物的使用与甲状腺疾病风险相关吗?一项回顾性队列研究的结果。

Is Statin Use Associated With Risk of Thyroid Diseases? Results of a Retrospective Cohort Study.

机构信息

University of Texas Southwestern, Dallas, TX, USA.

VA North Texas Health System, Dallas, TX, USA.

出版信息

Ann Pharmacother. 2021 Sep;55(9):1110-1119. doi: 10.1177/1060028020986552. Epub 2021 Jan 7.

Abstract

BACKGROUND

Given the ubiquity of statin use and prevalence of thyroid diseases, such as thyroid cancer, hyperthyroidism, and thyroiditis, understanding their association deserves further attention.

OBJECTIVE

To examine the association between statin use and thyroid cancer, thyrotoxicosis, goiter, and thyroiditis.

METHODS

Using Tricare data, 2 propensity score (PS)-matched cohorts of statin users and nonusers were formed: (1) a PS-matched general cohort (all patients aged 30-85 years) and (2) a PS-matched healthy cohort (excluded patients with cardiovascular diseases or severe comorbidities). Outcomes were thyroid cancer, thyrotoxicosis, goiter, and thyroiditis. Odds ratios (ORs) and 95% CIs of outcomes were estimated using conditional regression analysis.

RESULTS

Of 43 438 patients, the PS-matched general cohort matched 6342 statin users to 6342 nonusers. The OR of thyroid cancer was 0.62 (95% CI = 0.39-0.996). There was no significant difference between statin users and nonusers in risk of thyrotoxicosis (OR = 0.88; 95% CI = 0.71-1.09), goiter (OR = 0.9; 95% CI = 0.77-1.03), or thyroiditis (OR = 0.78; 95% CI = 0.53-1.15). In the PS-matched healthy cohort (3351 statin users to 3351 nonusers), there was no difference between statin users and nonusers in any outcome. Limitations of the study include its retrospective observational design and use of administrative codes in outcomes ascertainment.

CONCLUSION AND RELEVANCE

This study did not demonstrate any association of statins with harmful effects on thyroid diseases, which offers assurance to clinicians and patients. Furthermore, statin use appears to be associated with a decreased risk of thyroid cancer, but more studies are needed.

摘要

背景

鉴于他汀类药物的广泛应用以及甲状腺疾病(如甲状腺癌、甲状腺功能亢进症和甲状腺炎)的流行,研究它们之间的关联值得进一步关注。

目的

研究他汀类药物的使用与甲状腺癌、甲状腺毒症、甲状腺肿和甲状腺炎之间的关系。

方法

使用 Tricare 数据,通过倾向评分(PS)匹配方法构建了他汀类药物使用者和非使用者两组匹配队列:(1)PS 匹配的一般队列(所有年龄在 30-85 岁的患者)和(2)PS 匹配的健康队列(排除患有心血管疾病或严重合并症的患者)。观察指标为甲状腺癌、甲状腺毒症、甲状腺肿和甲状腺炎。使用条件回归分析估计结局的比值比(OR)及其 95%置信区间(CI)。

结果

在 43438 例患者中,PS 匹配的一般队列匹配了 6342 例他汀类药物使用者和 6342 例非使用者。甲状腺癌的 OR 为 0.62(95%CI=0.39-0.996)。他汀类药物使用者与非使用者在甲状腺毒症(OR=0.88;95%CI=0.71-1.09)、甲状腺肿(OR=0.9;95%CI=0.77-1.03)或甲状腺炎(OR=0.78;95%CI=0.53-1.15)的风险方面无显著差异。在 PS 匹配的健康队列(3351 例他汀类药物使用者和 3351 例非使用者)中,他汀类药物使用者与非使用者在任何结局方面均无差异。研究的局限性包括回顾性观察性设计和结局确定中使用行政代码。

结论和相关性

本研究未显示他汀类药物与甲状腺疾病的有害影响之间存在任何关联,这为临床医生和患者提供了保证。此外,他汀类药物的使用似乎与降低甲状腺癌的风险有关,但还需要更多的研究。

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