Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Pharmacoepidemiol Drug Saf. 2021 Jun;30(6):770-778. doi: 10.1002/pds.5205. Epub 2021 Feb 21.
Statins exert pleiotropic anti-inflammatory effects and may prevent diverticular disease. However, the association remains poorly understood with previous studies obtaining conflicting results.
To examine the effect of statin on the subsequent risk of diverticular disease.
We conducted a nested case-control study in Denmark among respondents (>18 years) of the 2010 or the 2013 Danish National Health Survey. Among these, we identified 8809 cases of hospital-diagnosed diverticular disease and risk-set sampled population controls without diverticular disease. Using complete prescription and hospital records, we used conditional logistic regression to compute odds ratios (ORs) associating statin use with diverticular disease. In adjusted analyses, we controlled for hospital-based diagnoses, medication use other than statins, and lifestyle and socioeconomic factors.
The fully adjusted OR for diverticular disease associated with ever use (≥1 statin prescription filling) was 1.19 (95% CI: 1.12-1.27) compared with never use. However, we observed no dose-response relation. For example, among short-term users (<5 years), the OR was 1.18 (95% CI: 1.04-1.35) for low intensity users and 1.13 (95% CI: 1.01-1.26) for high intensity users. Among long-term users (≥5 years), the respective ORs were 1.25 (95% CI: 1.13-1.38) and 1.11 (95% CI: 0.98-1.24). In analyses restricting to cases and controls with a previous colonoscopy, associations were null (OR: 1.01 [95% CI: 0.85-1.20]).
The observed association of a higher risk of diverticular disease associated with statins could be explained by diagnostic bias. Our study did not support a protective nor harmful effect of statins on the risk of diverticular disease.
他汀类药物具有多种抗炎作用，可能预防憩室病。然而，先前的研究结果相互矛盾，因此人们对这种关联的了解仍很有限。
研究他汀类药物对憩室病发病风险的影响。
我们在丹麦进行了一项嵌套病例对照研究，研究对象为参加了 2010 年或 2013 年丹麦全国健康调查的年龄在 18 岁以上的应答者。在这些应答者中，我们确定了 8809 例医院诊断的憩室病病例和无憩室病的风险设定人群对照。我们利用完整的处方和住院记录，采用条件逻辑回归计算使用他汀类药物与憩室病相关的比值比（OR）。在调整分析中，我们控制了医院诊断、除他汀类药物以外的药物使用以及生活方式和社会经济因素。
与从未使用过他汀类药物（从未使用过他汀类药物）相比，曾使用（≥1 次他汀类药物处方）与憩室病相关的完全调整 OR 为 1.19（95%CI：1.12-1.27）。然而，我们没有观察到剂量反应关系。例如，在短期使用者（<5 年）中，低强度使用者的 OR 为 1.18（95%CI：1.04-1.35），高强度使用者的 OR 为 1.13（95%CI：1.01-1.26）。在长期使用者（≥5 年）中，相应的 OR 分别为 1.25（95%CI：1.13-1.38）和 1.11（95%CI：0.98-1.24）。在仅纳入之前接受过结肠镜检查的病例和对照的分析中，关联为无效（OR：1.01 [95%CI：0.85-1.20]）。
观察到的与他汀类药物相关的憩室病发病风险较高可能可以用诊断偏差来解释。我们的研究不支持他汀类药物对憩室病发病风险有保护作用或有害作用。
