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. 2019 Dec;106(6):1338-1345.
doi: 10.1002/cpt.1553. Epub 2019 Jul 23.

Estrogen-Containing Oral Contraceptives Are Associated With Polycystic Liver Disease Severity in Premenopausal Patients

René M M van Aerts  1 , Lucas H P Bernts  1 , Tom J G Gevers  1 , Wietske Kievit  2 , Lisanne Koopmans  1 , Theodoor E Nieboer  3 , Frederik Nevens  4 , Joost P H Drenth  1
Affiliations

Estrogen-Containing Oral Contraceptives Are Associated With Polycystic Liver Disease Severity in Premenopausal Patients

René M M van Aerts et al. Clin Pharmacol Ther. 2019 Dec.

Abstract

The association between estrogen-containing oral contraceptives and history of pregnancies with disease severity in women with polycystic liver disease (PLD) is unclear. We performed a cross-sectional cohort study to assess this association by selecting female patients with PLD of which imaging was available prior to any liver volume-reducing therapy. Patients received a questionnaire to collect detailed information on estrogen use and pregnancies. Preplanned subgroup analyses were performed on premenopausal and postmenopausal patients. The questionnaire was returned by 287 of 360 selected patients (80%). There was no significant association between estrogen-containing oral contraceptives and height-adjusted total liver volume (hTLV) in the total group (P = 0.06) and postmenopausal subgroup (P = 0.7). By contrast, each year of exposure corresponds with a 1.45% higher hTLV (P = 0.02) in the premenopausal subgroup, equivalent to a 15.5% higher hTLV for every 10 years of use. Pregnancy duration was not associated with hTLV. In conclusion, patients with PLD should avoid exogenous estrogens.

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Conflict of interest statement

The authors declared no competing interests for this work.

Figures

Figure 1
Figure 1
Unadjusted linear regression analysis. Scatter plots and unadjusted (univariable) regression lines for estrogen‐containing oral contraceptives (years of use). (a) Shows the total group. (b) Shows the premenopausal. (c) Shows the postmenopausal subgroups. All data points represent individual patients. Natural logarithmic (Ln) transformed height‐adjusted total liver volume (hTLV) is presented on the y‐axis. P value and R 2 of the regression analysis are shown.
Figure 2
Figure 2
Categorical analysis. Categorical analysis for premenopausal (a) and postmenopausal subgroups (b). Estrogen‐containing oral contraceptives use (years) on the y‐axis and disease severity: mild (height‐adjusted total liver volume (hTLV) < 1,600 mL/m), moderate (hTLV 1,600–3,200 mL/m), and severe (>3,200 mL/m) on the x‐axis. All data points represent individual patients. Mean and 95% confidence interval are superimposed.
See this image and copyright information in PMC

References

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