Oophorectomy and risk of non-alcoholic fatty liver disease and primary liver cancer in the Clinical Practice Research Datalink
| Autor: | Jessica L. Petrick, Barry I. Graubard, Jake E. Thistle, Baiyu Yang, Katherine A. McGlynn, Marie C. Bradley, Andrea A. Florio |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Epidemiology Hormone Replacement Therapy medicine.medical_treatment Ovariectomy Population 030204 cardiovascular system & hematology Gastroenterology Article Body Mass Index 03 medical and health sciences 0302 clinical medicine Non-alcoholic Fatty Liver Disease Risk Factors Internal medicine medicine Humans 030212 general & internal medicine education Aged education.field_of_study business.industry Incidence (epidemiology) Incidence Fatty liver Liver Neoplasms Ovary Absolute risk reduction Oophorectomy Odds ratio Middle Aged medicine.disease Case-Control Studies Women's Health Female Liver cancer business |
| Zdroj: | Eur J Epidemiol |
| ISSN: | 1573-7284 |
| Popis: | Incidence of non-alcoholic fatty liver disease (NAFLD) and liver cancer are 2–3 times higher in males than females. Hormonal mechanisms are hypothesized, with studies suggesting that oophorectomy may increase risk, but population-based evidence is limited. Thus, we conducted a study within the Clinical Practice Research Datalink, with controls matched to cases of NAFLD (n = 10,082 cases/40,344 controls) and liver cancer (n = 767 cases/3068 controls). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression. Effect measure modification by menopausal hormone therapy (MHT) was examined, using likelihood ratio tests and relative excess risk due to interaction (RERI). Oophorectomy was associated with a 29% elevated NAFLD risk (OR = 1.29, 95% CI 1.18–1.43), which was more pronounced in women without diabetes (OR = 1.41, 95% CI 1.27–1.57) and in women who had oophorectomy prior to age 50 (OR = 1.37, 95% CI 1.22–1.52). Compared to women without oophorectomy or MHT use, oophorectomy and MHT were each associated with over 50% elevated risk of NAFLD. However, the combination of oophorectomy and MHT showed evidence of a negative interaction on the multiplicative (p = 0.003) and additive scales (RERI = − 0.28, 95% CI − 0.60 to 0.03, p = 0.08). Oophorectomy, overall, was not associated with elevated liver cancer risk (OR = 1.16, 95% CI 0.79–1.69). These findings suggest that oophorectomy may increase the risk of NAFLD, but not liver cancer. |
| Databáze: | OpenAIRE |
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