title: A population-based case-control study on statin exposure and risk of acute diverticular disease.
abstract: OBJECTIVE
  A reduced risk of perforated diverticular disease among individuals with current statin exposure has been reported. The aim of the present study was to investigate whether statins reduce the risk of acute diverticular disease.
  
  
  METHODS
  A nation-wide population-based case-control study was performed, including 13,127 cases hospitalised during 2006-2010 with a first-time diagnosis of colonic diverticular disease, and 128,442 control subjects (matched for sex, age, county of residence and calendar year). Emergency surgery, assumed to be a proxy for complicated diverticulitis, was performed on 906 of the cases during the index admission, with 8818 matched controls. Statin exposure was classified as "current" or "former" if a statin prescription was last dispensed ≤ 125 days or >125 days before index date, respectively. The association between statin exposure and acute diverticular disease was investigated by conditional logistic regression, including models adjusting for country of birth, educational level, marital status, comorbidities, nonsteroidal anti-inflammatory drug/steroid exposure and healthcare utilisation.
  
  
  RESULTS
  A total of 1959 cases (14.9%) and 16,456 controls (12.8%) were current statin users (crude OR 1.23 [95% CI 1.17-1.30]; fully adjusted OR 1.00 [0.94-1.06]). One hundred and thirty-two of the cases subjected to surgery (14.6%), and 1441 of the corresponding controls (16.3%) were current statin users (crude OR 0.89 [95% CI 0.73-1.08]; fully adjusted OR 0.70 [0.55-0.89]).
  
  
  CONCLUSIONS
  The results do not indicate that statins affect the development of symptomatic diverticular disease in general. However, current statin use was associated with a reduced risk of emergency surgery for diverticular disease.
authors.affiliation: a Department of Surgical Sciences , Uppsala University , Uppsala , Sweden .
authors.forename: Filip
authors.initials: F
authors.lastname: Sköldberg
authors.affiliation: b Clinical Epidemiology Unit, Department of Medicine Solna , Karolinska Institutet , Stockholm , Sweden .
authors.forename: Tobias
authors.initials: T
authors.lastname: Svensson
authors.affiliation: b Clinical Epidemiology Unit, Department of Medicine Solna , Karolinska Institutet , Stockholm , Sweden .|c Sachs' Children and Youth Hospital , Södersjukhuset , Stockholm , Sweden .|d Department of Clinical Science and Education , Södersjukhuset, Karolinska Institutet , Stockholm , Sweden .
authors.forename: Ola
authors.initials: O
authors.lastname: Olén
authors.affiliation: e Division of Surgery, Department of Clinical Sciences , Danderyd University Hospital , Stockholm , Sweden .
authors.forename: Fredrik
authors.initials: F
authors.lastname: Hjern
authors.affiliation: f Unit of Gastroenterology and Hepatology, Department of Medicine , Karolinska Institutet , Stockholm , Sweden , and.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Schmidt
authors.affiliation: g Unit of Epidemiology , Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden.
authors.forename: Rickard
authors.initials: R
authors.lastname: Ljung
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004239:Diverticulitis, Colonic / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery; D004630:Emergencies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D065840:Protective Factors; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Case–control studies; diverticulitis; hydroxymethylglutaryl-CoA reductase inhibitors; pharmacoepidemiology