Role of fibrates and HMG-CoA reductase inhibitors in gallstone formation epidemiological - Study in an unselected population

Fibrate derivatives and HMG-CoA reductase inhibitors modify homeostasis of cholesterol. The aim of this study was to assess in an unselected populatio n whether these hypolipidemic drugs are risk factors for cholelithiasis or, conversely, are protective agents. Both sexes, all socioeconomic categorie s, pregnant women and cholecystectomized subjects were included. Clinical d ata collection and gallbladder ultrasonography were both carried out in a d ouble-blind fashion. Fibrate derivatives were predominantly fenofibrate, HM G-CoA reductase inhibitors were simvastatin and pravastatin. On univariate analysis, age (>50 years), sex, and use of fibrates were found to be signif icantly related to the presence of cholelithiasis. Age, sex, and fibrate tr eatment remained independently correlated with the presence of gallstones o n multivariate analysis. With fibrates, the relative risk for lithiasis was 1.7 (P = 0.04). The HMG-CoA reductase inhibitors were not associated with a protective effect on univariate analysis. Of the lipid-lowering drugs, on ly fibrate derivatives were found to increase the risk of gallstone formati on.