Menopausal hormone therapy is not associated with gallbladder disease. Results from a population-based study

Abstract

Objectives: There is a large body of evidence of risk and benefits of menopausal hormone therapy (MHT). One among several safety concerns is the risk of gallstone formation and of gallbladder surgery. An increased risk of gallbladder disease might be explained by effects of oral MHT on hepatic lipid metabolism. Nonoral MHT avoids first-pass hepatic metabolism. Therefore it has been hypothesized that nonoral MHT may decrease the risk of cholelithiasis. The objective of the present study was to analyse the association between (1) use of life-time MHT (ever use) and gallbladder disease, and (2) nonoral use of MHT and gallbladder disease using data of the population-based Study of Health in Pomerania (SHIP). Methods: The study population included 994 postmenopausal women, aged 40–79 years. The subgroup of current oral and nonoral MHT users comprised 139 women. Gallbladder disease was defined as previous history of cholecystectomy or presence of current, sonographically diagnosed gallstones. Socio-demographic, medical, and reproductive characteristics were based on computer-assisted personal interviews, and selected laboratory parameters were analysed. We performed Poisson regression with Huber / White standard errors to investigate the association between ever use respective current nonoral use of MHT and gallbladder disease. Results: We found no significant association between ever use of MHT and gallbladder disease and sonographically diagnosed gallstones in fully adjusted analyses. Women who used MHT had a significantly higher risk for cholecystectomy compared to non users. There was no association between nonoral use of MHT and gallbladder disease. Conclusion: Our analyses do not lend support to the hypothesis that the use of MHT is associated with gallbladder disease. We did not identify a preferential role for nonoral MHT to reduce the pertinent risk for gallbladder disease.