Introduction: Statin may induce epithelial dysfunction of the bladder urothelium. Epithelial dysfunction was proposed as one of the major potential etiologies for bladder pain syndrome/interstitial cystitis (BPS/IC). In this study, we examined the association between statin use and BPS/IC using a population-based study. Subjects and Methods: This case-control study used the Taiwan Longitudinal Health Insurance Database. In total, 815 female subjects with BPS/IC and 4075 randomly selected female controls were included. We used a conditional logistic regression to compute the odds ratio (OR) for having previously used statins between cases and controls. Results: A conditional logistic regression analysis showed that the OR of prior statin users for cases was 1.52 (95% confidence interval (CI): 1.19-1.94) compared to controls after adjusting for diabetes, hypertension, coronary heart disease, obesity, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, and asthma. Furthermore, adjusted ORs of regular and irregular statin use for cases were 1.58 (95% CI: 1.20-2.08) and 1.53 (95% CI: 1.02-2.31), respectively, compared to controls. Conclusion: We concluded that there was an association between statin use and BPS/IC.

1.
Berry SH, Elliott MN, Suttorp M, Bogart LM, Stoto MA, Eggers P, et al: Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States. J Urol 2011;186:540-544.
2.
Wang CY, Liu PY, Liao JK: Pleiotropic effects of statin therapy: molecular mechanisms and clinical results. Trends Mol Med 2008;14:37-44.
3.
Chopra V, Rogers MA, Buist M, Govindan S, Lindenauer PK, Saint S, et al: Is statin use associated with reduced mortality after pneumonia? A systematic review and meta-analysis. Am J Med 2012;125:1111-1123.
4.
Doshi SM, Kulkarni PA, Liao JM, Rueda AM, Musher DM: The Impact of statin and macrolide use on early survival in patients with pneumococcal pneumonia. Am J Med Sci 2013;345:173-177.
5.
Alexandre L, Clark AB, Cheong E, Lewis MP, Hart AR: Systematic review: potential preventive effects of statins against oesophageal adenocarcinoma. Aliment Pharmacol Ther 2012;36:301-311.
6.
Scosyrev E, Tobis S, Donsky H, et al: Statin use and the risk of biochemical recurrence of prostate cancer after definitive local therapy: a meta-analysis of eight cohort studies. BJU Int 2013;111(3 pt B):E71-E77.
7.
Sampson UK, Linton MF, Fazio S: Are statins diabetogenic? Curr Opin Cardiol 2011;26:342-347.
8.
Zaharan NL, Williams D, Bennett K: Statins and risk of treated incident diabetes in a primary care population. Br J Clin Pharmacol 2013;75:1118-1124.
9.
Murtola TJ, Syvälä H, Pennanen P, et al: Comparative effects of high and low-dose simvastatin on prostate epithelial cells: the role of LDL. Eur J Pharmacol 2011;673:96-100.
10.
Parsons CL: Interstitial cystitis: epidemiology and clinical presentation. Clin Obstet Gynecol 2002;45:242-249.
11.
Kang JH, Chen YH, Lin HC: Comorbidity profiles among patients with ankylosing spondylitis: a nationwide population-based study. Ann Rheum Dis 2010;69:1165-1168.
12.
Chung KH, Liu SP, Lin HC, Chung SD: Bladder pain syndrome/interstitial cystitis is associated with anxiety disorder. Neurourol Urodyn 2014;33:101-105.
13.
Chung SD, Liu SP, Lin CC, Li HC, Lin HC: Bladder pain syndrome/interstitial cystitis is associated with hyperthyroidism. PLoS One 2013;8:e72284.
14.
Hung SH, Wang LH, Lin HC, Chung SD: Association between statin use and Bell's palsy: a population-based study. Drug Saf 2014;37:735-742.
15.
Hung SH, Lin HC, Chung SD: Statin use and thyroid cancer: a population-based case-control study. Clin Endocrinol (Oxf) 2014, Epub ahead of print.
16.
Buffington CA: Comorbidity of interstitial cystitis with other unexplained clinical conditions. J Urol 2004;172(4 pt 1):1242-1248.
17.
Kang JH, Keller JJ, Chen YK, Lin HC: Reflux esophagitis increased the risk of bladder pain syndrome/interstitial cystitis: a 3-year follow-up study. Neurourol Urodyn 2013;32:271-275.
18.
Chung SD, Lin CC, Liu SP, Lin HC: Obstructive sleep apnea increases the risk of bladder pain syndrome/interstitial cystitis: a population-based matched-cohort study. Neurourol Urodyn 2014;33:278-282.
19.
Cheng CL, Kao YH, Lin SJ, Lee CH, Lai ML: Validation of the national health insurance research database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf 2011;20:236-242.
20.
Costantini E, Lazzeri M, Pistolesi D, et al: Morphological changes of bladder mucosa in patients who underwent instillation with combined sodium hyaluronic acid-chondroitin sulphate (Ialuril®). Urol Int 2013;91:81-88.
21.
Liu BL, Yang F, Zhan HL, et al: Increased severity of inflammation correlates with elevated expression of TRPV1 nerve fibers and nerve growth factor on interstitial cystitis/bladder pain syndrome. Urol Int 2014;92:202-208.
22.
Shie JH, Kuo HC: Higher levels of cell apoptosis and abnormal E-cadherin expression in the urothelium are associated with inflammation in patients with interstitial cystitis/painful bladder syndrome. BJU Int 2011;108(2 pt 2):E136-E141.
23.
Shie JH, Liu HT, Kuo HC: Increased cell apoptosis of urothelium mediated by inflammation in interstitial cystitis/painful bladder syndrome. Urology 2012;79:484.e7-e13.
24.
Yamada T, Nishimura M, Mita H: Increased number of apoptotic endothelial cells in bladder of interstitial cystitis patients. World J Urol 2007;25:407-413.
25.
Kutlu O, Akkaya E, Koksal IT, Bassorgun IC, Ciftcioglu MA, Sanlioglu S, et al: Importance of TNF-related apoptosis-inducing ligand in pathogenesis of interstitial cystitis. Int Urol Nephrol 2010;42:393-399.
26.
Padayatty SJ, Marcelli M, Shao TC, et al: Lovastatin-induced apoptosis in prostate stromal cells. J Clin Endocrinol Metab 1997;82:1434-1439.
27.
Anderson TJ, Meredith IT, Yeung AC, et al: The effect of cholesterol-lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med 1995;332:488-493.
28.
Zeuke S, Ulmer AJ, Kusumoto S, Katus HA, Heine H: TLR4-mediated inflammatory activation of human coronary artery endothelial cells by LPS. Cardiovasc Res 2002;56:126-134.
29.
Lee DK, Park EJ, Kim EK, Jin J, Kim JS, Shin IJ, et al: Atorvastatin and simvastatin, but not pravastatin, up-regulate LPS-induced MMP-9 expression in macrophages by regulating phosphorylation of ERK and CREB. Cell Physiol Biochem 2012;30:499-511.
30.
Liao YH, Lin YC, Tsao ST, Lin YC, Yang AJ, Huang CT, et al: HMG-CoA reductase inhibitors activate caspase-1 in human monocytes depending on ATP release and P2X7 activation. J Leukoc Biol 2013;93:289-299.
31.
Kuijk LM, Beekman JM, Koster J, Waterham HR, Frenkel J, Coffer PJ: HMG-CoA reductase inhibition induces IL-1beta release through Rac1/PI3K/PKB-dependent caspase-1 activation. Blood 2008;112:3563-3573.
32.
Chong PH, Boskovich A, Stevkovic N, Bartt RE: Statin-associated peripheral neuropathy: review of the literature. Pharmacotherapy 2004;24:1194-1203.
33.
Ziajka PE, Wehmeier T: Peripheral neuropathy and lipid-lowering therapy. South Med J 1998;91:667-668.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.