ArticlePloS one2023
Menopausal hormone therapy increases the risk of gallstones: Health Insurance Database in South Korea (HISK)-based cohort study.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 7 citations in OpenAlex.
- Risk stratification for gallstones based on 14 obesity and lipid-related Indices: a longitudinal cohort study of 44,030 Chinese adults.Lipids in health and disease · 2026Article
- Evaluating the liver fibrosis and waist-to-height ratio(LFWHR) as a gallstone disease predictor: a nomogram model and SHAP analysis.Scientific reports · 2025Article
- Genetics of Gallstones.Genes · 2025Review
- Higher triglyceride glucose-waist height ratio index is associated with higher prevalence of gallstone: a population-based study.Frontiers in medicine · 2024Article
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Authors and funding
2 authors at 1 institution in 1 country.
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Abstract
objectiveTo determine whether menopausal hormone therapy (MHT) increases the risk of gallstones and gallbladder cancer.
designA retrospective cohort study. PATIENTS OR OTHER
participantsData from the Korea National Health Insurance Corporation was obtained between January 1, 2002, and December 31, 2019.
interventionsParticipants were divided into MHT and non-MHT groups; the MHT group was analyzed in detail by dividing participants into tibolone, combined estrogen plus progestin by the manufacturer (CEPM) or physician (CEPP), oral estrogen alone, and topical estrogen subgroups.
main outcome measuresThe incidence of gallstones and gallbladder cancer was compared between the two groups.
resultsThis study enrolled 1,004,034 and 381,711 patients in the non-MHT and the MHT groups, respectively. The incidence of gallstones was 2.6% in the non-MHT group and 3.4%, 2.6%, 3.4%, 3.2%, and 4.4% in the tibolone, CEPM, oral estrogen alone, CEPP, and topical estrogen groups, respectively. Cox proportional hazard analysis revealed that all hormones increased the risk of gallstones ([tibolone] hazard ratio [HR]: 1.347, 95% confidence interval [CI]: 1.309-1.387, [CEPM] HR: 1.146, 95% CI: 1.1-1.19, [oral estrogen alone] HR: 1.241, 95% CI: 1.18-1.305, [CEPP] HR: 1.164, 95% CI: 1.01-1.341, [topical estrogen] HR: 1.602, 95% CI: 1.295-1.983). However, the risk of gallbladder cancer did not change with any hormone therapy.
conclusionsAll types of MHT including tibolone, increased the risk of gallstones. This risk was the highest with topical estrogen, which may be a result of selection bias due to concerns regarding the adverse effects of CEE and MPA.
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