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Reduced Risk of Barrett’s Esophagus in Statin Users: Case–Control Study and Meta-Analysis

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Abstract

Background

Use of statins has been associated with a reduced incidence of esophageal adenocarcinoma in population-based studies. However there are few studies examining statin use and the development of Barrett’s esophagus.

Aim

The purpose of this study was to examine the association between statin use and the presence of Barrett’s esophagus in patients having their first gastroscopy.

Methods

We have performed a case–control study comparing statin use between patients with, and without, an incident diagnosis of non-dysplastic Barrett’s esophagus. Male Barrett’s cases (134) were compared to 268 male age-matched controls in each of two control groups (erosive gastro-esophageal reflux and dyspepsia without significant upper gastrointestinal disease). Risk factor and drug exposure were established using standardised interviews. Logistic regression was used to compare statin exposure and correct for confounding factors. We performed a meta-analysis pooling our results with three other case–control studies.

Results

Regular statin use was associated with a significantly lower incidence of Barrett’s esophagus compared to the combined control groups [adjusted OR 0.62 (95 % confidence intervals 0.37–0.93)]. This effect was more marked in combined statin plus aspirin users [adjusted OR 0.43 (95 % CI 0.21–0.89)]. The inverse association between statin or statin plus aspirin use and risk of Barrett’s was significantly greater with longer duration of use. Meta-analysis of pooled data (1098 Barrett’s, 2085 controls) showed that statin use was significantly associated with a reduced risk of Barrett’s esophagus [pooled adjusted OR 0.63 (95 % CI 0.51–0.77)].

Conclusions

Statin use is associated with a reduced incidence of a new diagnosis of Barrett’s esophagus.

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Abbreviations

aOR:

Adjusted odds ratio

BE:

Barrett’s esophagus

CI:

Confidence interval

COX:

Cyclo-oxygenase

EAC:

Esophageal adenocarcinoma

NSAID:

Non-steroidal anti-inflammatory drug

OR:

Odds ratio

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Acknowledgments

We would like to thank the staff of the Gastroenterology unit at the Norfolk and Norwich University Hospital for their help with the study. All authors jointly conceived the study, LD, IV and ILPB collected the data and all authors analysed the data. ILPB designed the study, wrote the paper and is the guarantor of the paper. All authors approved the final version of the manuscript.

Funding

No funding was received in support of the study.

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Authors and Affiliations

  1. Department of Gastroenterology, Norfolk and Norwich University Hospital, Norwich, NR4 7UZ, UK

    Ian L. P. Beales, Leanne Dearman & Inna Vardi

  2. School of Medicine, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK

    Ian L. P. Beales & Yoon Loke

Authors
  1. Ian L. P. Beales
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  2. Leanne Dearman
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Correspondence to Ian L. P. Beales.

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Beales, I.L.P., Dearman, L., Vardi, I. et al. Reduced Risk of Barrett’s Esophagus in Statin Users: Case–Control Study and Meta-Analysis. Dig Dis Sci 61, 238–246 (2016). https://doi.org/10.1007/s10620-015-3869-4

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  • DOI: https://doi.org/10.1007/s10620-015-3869-4

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