title: Statin use and uterine fibroid risk in hyperlipidemia patients: a nested case-control study.
abstract: BACKGROUND
  Statins are 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors primarily used for treatment of hyperlipidemia. Recently, they have been shown to inhibit proliferation of uterine fibroid cells and inhibit tumor growth in fibroid animal models.
  
  
  OBJECTIVE
  We sought to examine the association between statin use and the risk of uterine fibroids and fibroid-related symptoms in a nationally representative sample of commercially insured women diagnosed with hyperlipidemia.
  
  
  METHODS
  We performed a nested case-control study of >190,000 women enrolled in one of the nation's largest commercial health insurance programs. From a cohort of women aged 18-65 years diagnosed with hyperlipidemia from January 2004 through March 2011, we identified 47,713 cases (women diagnosed with uterine fibroids) and 143,139 controls (women without uterine fibroids) matched at a 1:3 ratio on event/index date (month and year) and age (±1 year). We used conditional and unconditional logistic regression to calculate odds ratios and 95% confidence intervals for the risk of uterine fibroids and fibroid-related symptoms associated with prior use of statins.
  
  
  RESULTS
  Exposure to statins within 2 years before the event/index date was associated with a decreased risk of uterine fibroids (odds ratio, 0.85; 95% confidence interval, 0.83-0.87). In a separate subanalysis restricted to cases, statin users had a lower likelihood of having menorrhagia (odds ratio, 0.88; 95% confidence interval, 0.84-0.91), anemia (odds ratio, 0.84; 95% confidence interval, 0.79-0.88), or pelvic pain (odds ratio, 0.85; 95% confidence interval, 0.81-0.91) and of undergoing myomectomy (odds ratio, 0.76; 95% confidence interval, 0.66-0.87) compared to nonusers.
  
  
  CONCLUSIONS
  The use of statins was associated with a lower risk of uterine fibroids and fibroid-related symptoms. Further studies, including randomized controlled trials, may be warranted.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX; Department of Biochemistry and Molecular Biology, University of Texas Health Science Center at Houston, Houston, TX. Electronic address: maboraha@utmb.edu.
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Borahay
authors.affiliation: Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, TX.
authors.forename: Xiao
authors.initials: X
authors.lastname: Fang
authors.affiliation: Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, TX.
authors.forename: Jacques G
authors.initials: JG
authors.lastname: Baillargeon
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX.
authors.forename: Gokhan S
authors.initials: GS
authors.lastname: Kilic
authors.affiliation: Department of Biochemistry and Molecular Biology, University of Texas Health Science Center at Houston, Houston, TX.
authors.forename: Darren F
authors.initials: DF
authors.lastname: Boehning
authors.affiliation: Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, TX.
authors.forename: Yong-Fang
authors.initials: YF
authors.lastname: Kuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy*; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007889:Leiomyoma / Q000453:epidemiology*; D016015:Logistic Models; D008595:Menorrhagia / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D017699:Pelvic Pain / Q000453:epidemiology*; D065840:Protective Factors; D014481:United States / Q000453:epidemiology; D063186:Uterine Myomectomy / Q000706:statistics & numerical data*; D014594:Uterine Neoplasms / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: fibroids; leiomyoma; menorrhagia; pelvic pain; statins