title: Reduced Risk of Barrett's Esophagus in Statin Users: Case-Control Study and Meta-Analysis.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Gastroenterology, Norfolk and Norwich University Hospital, Norwich, NR4 7UZ, UK. i.beales@uea.ac.uk.|School of Medicine, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK. i.beales@uea.ac.uk.
authors.forename: Ian L P
authors.identifier: http://orcid.org/0000-0003-1923-3237
authors.initials: IL
authors.lastname: Beales
authors.affiliation: Department of Gastroenterology, Norfolk and Norwich University Hospital, Norwich, NR4 7UZ, UK.
authors.forename: Leanne
authors.initials: L
authors.lastname: Dearman
authors.affiliation: Department of Gastroenterology, Norfolk and Norwich University Hospital, Norwich, NR4 7UZ, UK.
authors.forename: Inna
authors.initials: I
authors.lastname: Vardi
authors.affiliation: School of Medicine, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
authors.forename: Yoon
authors.initials: Y
authors.lastname: Loke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004739:England / Q000453:epidemiology; D005773:Gastroscopy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin
keywords: Aspirin; Barrett’s esophagus; Esophageal cancer; Statins