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エストロゲン療法が胆管疾患に与える影響
Dominic J Cirillo1, Robert B Wallace, Rebecca J Rodabough
1Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, USA.
JAMA
|January 20, 2005
まとめ
エストロゲン療法を用いる閉経後の女性は,結合馬性エストロゲン (CEE) とエストロゲンプラスプロゲスチン (E + P) を含め,胆囊炎や胆石病を含む胆囊疾患のリスクが著しく増加します.
科学分野:
- エンドクリノロジー エンドクリノロジー
- 胃腸内科 胃腸内科
- 女性の健康 女性の健康
背景:
- エストロゲン療法は,通常,胆石形成と胆囊炎に関連しています.
- 既存のデータは主に観察研究から得られており,ランダム化試験の厳しさが欠けています.
研究 の 目的:
- 健康な閉経後の女性における胆管疾患のアウトカムに対するエストロゲン療法の影響を調査する.
- 胆管の健康に対するエストロゲンの影響に関するランダム化対照試験からの証拠を提供するため.
主な方法:
- 2つの大規模,ランダム化,ダブルブラインド,プラセボ対照試験で,22,000人以上の閉経後の女性が参加しました.
- 参加者は,コンジュガド・エクイネ・エストロゲン (CEE) またはエストロゲン・プラス・プロゲステン (E+P) またはプラセボを投与された.
- 胆小管疾患の発生および処置は,コックス比例リスク回帰を用いて追跡および分析されました.
主要な成果:
- エストロゲン療法は,胆管疾患または手術のリスクを大幅に増加させました (HR 1.67 for CEE, 1.59 for E + P).
- 胆炎 (CH 1.80 for CEE, 1.54 for E + P) と胆症 (CH 1.86 for CEE, 1.68 for E + P) のリスクは高かった.
- エストロゲン使用者はコレシステクトミーを受ける可能性が高くなりました.
結論:
- エストロゲン療法を使用している閉経後の女性は,胆道疾患のリスクが高くなります.
- 罹病率の増加と関連する費用は,エストロゲン療法を処方する際に慎重に検討する必要があります.
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