PMID- 38048308
OWN - NLM
STAT- MEDLINE
DCOM- 20231206
LR  - 20231206
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 18
IP  - 12
DP  - 2023
TI  - Menopausal hormone therapy increases the risk of gallstones: Health Insurance 
      Database in South Korea (HISK)-based cohort study.
PG  - e0294356
LID - 10.1371/journal.pone.0294356 [doi]
LID - e0294356
AB  - OBJECTIVE: To determine whether menopausal hormone therapy (MHT) increases the 
      risk of gallstones and gallbladder cancer. DESIGN: A retrospective cohort study. 
      PATIENTS OR OTHER PARTICIPANTS: Data from the Korea National Health Insurance 
      Corporation was obtained between January 1, 2002, and December 31, 2019. 
      INTERVENTIONS: Participants were divided into MHT and non-MHT groups; the MHT 
      group was analyzed in detail by dividing participants into tibolone, combined 
      estrogen plus progestin by the manufacturer (CEPM) or physician (CEPP), oral 
      estrogen alone, and topical estrogen subgroups. MAIN OUTCOME MEASURES: The 
      incidence of gallstones and gallbladder cancer was compared between the two 
      groups. RESULTS: This study enrolled 1,004,034 and 381,711 patients in the 
      non-MHT and the MHT groups, respectively. The incidence of gallstones was 2.6% in 
      the non-MHT group and 3.4%, 2.6%, 3.4%, 3.2%, and 4.4% in the tibolone, CEPM, 
      oral estrogen alone, CEPP, and topical estrogen groups, respectively. Cox 
      proportional hazard analysis revealed that all hormones increased the risk of 
      gallstones ([tibolone] hazard ratio [HR]: 1.347, 95% confidence interval [CI]: 
      1.309-1.387, [CEPM] HR: 1.146, 95% CI: 1.1-1.19, [oral estrogen alone] HR: 1.241, 
      95% CI: 1.18-1.305, [CEPP] HR: 1.164, 95% CI: 1.01-1.341, [topical estrogen] HR: 
      1.602, 95% CI: 1.295-1.983). However, the risk of gallbladder cancer did not 
      change with any hormone therapy. CONCLUSIONS: All types of MHT including 
      tibolone, increased the risk of gallstones. This risk was the highest with 
      topical estrogen, which may be a result of selection bias due to concerns 
      regarding the adverse effects of CEE and MPA.
CI  - Copyright: (c) 2023 Yuk, Park. This is an open access article distributed under the 
      terms of the Creative Commons Attribution License, which permits unrestricted 
      use, distribution, and reproduction in any medium, provided the original author 
      and source are credited.
FAU - Yuk, Jin-Sung
AU  - Yuk JS
AD  - Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of 
      Medicine, Inje University, Seoul, Republic of Korea.
FAU - Park, Ji Young
AU  - Park JY
AUID- ORCID: 0000-0002-5299-3820
AD  - Department of Internal Medicine, Sanggye Paik Hospital, School of Medicine, Inje 
      University, Seoul, Republic of Korea.
LA  - eng
PT  - Journal Article
DEP - 20231204
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Estrogens)
RN  - 0 (Progestins)
SB  - IM
MH  - Female
MH  - Humans
MH  - *Gallstones/chemically induced/epidemiology
MH  - Cohort Studies
MH  - *Gallbladder Neoplasms
MH  - Estrogen Replacement Therapy/adverse effects
MH  - Retrospective Studies
MH  - Estrogens/adverse effects
MH  - Progestins/adverse effects
MH  - Menopause
MH  - Insurance, Health
PMC - PMC10695378
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/12/04 19:43
MHDA- 2023/12/06 06:42
PMCR- 2023/12/04
CRDT- 2023/12/04 13:33
PHST- 2022/10/05 00:00 [received]
PHST- 2023/10/30 00:00 [accepted]
PHST- 2023/12/06 06:42 [medline]
PHST- 2023/12/04 19:43 [pubmed]
PHST- 2023/12/04 13:33 [entrez]
PHST- 2023/12/04 00:00 [pmc-release]
AID - PONE-D-22-27474 [pii]
AID - 10.1371/journal.pone.0294356 [doi]
PST - epublish
SO  - PLoS One. 2023 Dec 4;18(12):e0294356. doi: 10.1371/journal.pone.0294356. 
      eCollection 2023.