Is Statin Use Associated With Risk of Thyroid Diseases? Results of a Retrospective Cohort Study

Ann Pharmacother. 2021 Sep;55(9):1110-1119. doi: 10.1177/1060028020986552. Epub 2021 Jan 7.

Abstract

Background: Given the ubiquity of statin use and prevalence of thyroid diseases, such as thyroid cancer, hyperthyroidism, and thyroiditis, understanding their association deserves further attention.

Objective: To examine the association between statin use and thyroid cancer, thyrotoxicosis, goiter, and thyroiditis.

Methods: Using Tricare data, 2 propensity score (PS)-matched cohorts of statin users and nonusers were formed: (1) a PS-matched general cohort (all patients aged 30-85 years) and (2) a PS-matched healthy cohort (excluded patients with cardiovascular diseases or severe comorbidities). Outcomes were thyroid cancer, thyrotoxicosis, goiter, and thyroiditis. Odds ratios (ORs) and 95% CIs of outcomes were estimated using conditional regression analysis.

Results: Of 43 438 patients, the PS-matched general cohort matched 6342 statin users to 6342 nonusers. The OR of thyroid cancer was 0.62 (95% CI = 0.39-0.996). There was no significant difference between statin users and nonusers in risk of thyrotoxicosis (OR = 0.88; 95% CI = 0.71-1.09), goiter (OR = 0.9; 95% CI = 0.77-1.03), or thyroiditis (OR = 0.78; 95% CI = 0.53-1.15). In the PS-matched healthy cohort (3351 statin users to 3351 nonusers), there was no difference between statin users and nonusers in any outcome. Limitations of the study include its retrospective observational design and use of administrative codes in outcomes ascertainment.

Conclusion and relevance: This study did not demonstrate any association of statins with harmful effects on thyroid diseases, which offers assurance to clinicians and patients. Furthermore, statin use appears to be associated with a decreased risk of thyroid cancer, but more studies are needed.

Keywords: goiter; statins; thyroid cancer; thyroiditis; thyrotoxicosis.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cohort Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Odds Ratio
  • Propensity Score
  • Retrospective Studies
  • Risk Factors
  • Thyroid Diseases* / chemically induced
  • Thyroid Diseases* / epidemiology

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors