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

Racine, Antoine; Bijon, Anne; Fournier, Agnès; Mesrine, Sylvie; Clavel‐Chapelon, Françoise; Carbonnel, Franck; Boutron‐Ruault, Marie‐Christine

doi:10.1503/cmaj.121490

Cited by 32 publications

(17 citation statements)

References 30 publications

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“…However, the conclusions are based on self‐assessment of physical activity and must therefore be interpreted with this in mind. Previous studies have reported that HRT is a risk factor for gallstones and cholecystectomy, as in the present study. A possible increased risk of cholecystectomy in women with many children and in those taking oral contraceptives has been discussed in previous reports, but this was not confirmed in the present study.…”

Section: Discussionsupporting

confidence: 80%

“…In addition, the prevalence of gallstone disease in a population appears to have little influence on the incidence of gallbladder surgery. Several studies have assessed risk factors for gallstones. However, they focused on the risk of gallstone formation and did not consider symptomatic disease or cholecystectomy as an endpoint.…”

Section: Introductionmentioning

confidence: 99%

“…Seven of ten cholecystectomies are performed in women, both in the past and present era. Overweight, parity, hormone replacement therapy (HRT) and use of contraceptive medications have been suggested as risk factors for cholecystectomy. However, most previous studies have been performed in selected groups of patients, mainly postmenopausal women, and not in an unselected general population.…”

Section: Introductionmentioning

confidence: 99%

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

Talseth

Ness-Jensen

Edna

et al. 2016

British Journal of Surgery

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BackgroundThe relationship between different lifestyle factors and the risk of needing cholecystectomy for gallstone disease is not clear. This study aimed to assess the association between anthropometric, lifestyle and sociodemographic risk factors and the subsequent risk of requiring cholecystectomy for gallstone disease during long‐term follow‐up in a defined population cohort.MethodsData from a large population‐based cohort study performed from 1995 to 1997 were used (the second Norwegian Nord‐Trøndelag health study, HUNT2). Following HUNT2, from 1998 to 2011, all patients operated on for gallstone disease with cholecystectomy at the two hospitals in the county, Levanger Hospital and Namsos Hospital, were identified. A Cox proportional hazards model was used for multivariable risk analysis.ResultsThe HUNT2 cohort included 65 237 individuals (69·5 per cent response rate), aged 20–99 years. During a median follow‐up of 15·3 (range 0·6–16·4) years, 1162 cholecystectomies were performed. In multivariable analysis, overweight individuals (body mass index (BMI) 25·0–29·9 kg/m2) had a 58 per cent increased risk of cholecystectomy compared with individuals with normal weight (BMI less than 25·0 kg/m2). Obese individuals (BMI 30 kg/m2 or above) had a twofold increased risk. Increasing waist circumference independently increased the risk of cholecystectomy. In women, current hormone replacement therapy (HRT) increased the risk, whereas hard physical activity and higher educational level were associated with reduced risk of cholecystectomy.ConclusionHigh BMI and waist circumference increased the risk of having cholecystectomy for both sexes. In women, the risk was increased by HRT, and decreased by hard physical activity and higher educational level.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Talseth

Ness-Jensen

Edna

et al. 2016

British Journal of Surgery

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“…Risk persisted at least 5 years after cessation of EPT (44,120). Observational studies report increased risk with oral, but not transdermal, estradiol (121,122) and increased dose and duration (120,123).…”

Section: Gallbladder Diseasementioning

confidence: 99%

Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline

Stuenkel

Davis

Gompel

et al. 2015

The Journal of Clinical Endocrinology & Metabolism

638

419

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Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and other symptoms of the climacteric. Benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or under 10 years since the onset of menopause. Health care professionals should individualize therapy based on clinical factors and patient preference. They should screen women before initiating MHT for cardiovascular and breast cancer risk and recommend the most appropriate therapy depending on risk/benefit considerations. Current evidence does not justify the use of MHT to prevent coronary heart disease, breast cancer, or dementia. Other options are available for those with vasomotor symptoms who prefer not to use MHT or who have contraindications because these patients should not use MHT. Low-dose vaginal estrogen and ospemifene provide effective therapy for the genitourinary syndrome of menopause, and vaginal moisturizers and lubricants are available for those not choosing hormonal therapy. All postmenopausal women should embrace appropriate lifestyle measures.

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“…In their CMAJ article, Racine and colleagues report on the rates of cholecystectomy in a study involving more than 70 000 women in France, where transdermal menopausal hormone therapy is much more commonly prescribed than oral preparations. 1 In their observational prospective study, Racine and colleagues obtained data on meno pausal hormone therapy and cholecystectomy from questionnaires completed by the participants every 2 years. The type of hormone therapy used was updated in analyses throughout the follow-up period.…”

mentioning

confidence: 99%

Is transdermal menopausal hormone therapy a safer option than oral therapy?

Liu

2013

CMAJ

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

Cited by 32 publications

References 30 publications

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

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

Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline

Is transdermal menopausal hormone therapy a safer option than oral therapy?

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