Association Between Use of Antihyperlipidemic Agents and Chronic Obstructive Pulmonary Disease in Patients with Hyperlipidemia: A Population-Based Retrospective Cohort Study

Yi-Fen Lei,1,2 Hsiu-Chen Lin,3,4 Hsiu-Li Lin,5 Yow-Sheng Uang,2 Hui-Wen Cheng,2 Li-Hsuan Wang2,6 1Department of Pharmacy, Mackay Memorial Hospital, Taipei 10449, Taiwan; 2School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan; 3Department of Pediatrics, School of Me...

Full description

Bibliographic Details
Main Authors: Lei YF, Lin HC, Lin HL, Uang YS, Cheng HW, Wang LH
Format: Article
Language:English
Published: Dove Medical Press 2020-10-01
Series:International Journal of COPD
Subjects:
Online Access:https://www.dovepress.com/association-between-use-of-antihyperlipidemic-agents-and-chronic-obstr-peer-reviewed-article-COPD
_version_ 1818409091518693376
author Lei YF
Lin HC
Lin HL
Uang YS
Cheng HW
Wang LH
author_facet Lei YF
Lin HC
Lin HL
Uang YS
Cheng HW
Wang LH
author_sort Lei YF
collection DOAJ
description Yi-Fen Lei,1,2 Hsiu-Chen Lin,3,4 Hsiu-Li Lin,5 Yow-Sheng Uang,2 Hui-Wen Cheng,2 Li-Hsuan Wang2,6 1Department of Pharmacy, Mackay Memorial Hospital, Taipei 10449, Taiwan; 2School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan; 3Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; 4Department of Clinical Pathology, Taipei Medical University Hospital, Taipei 11031, Taiwan; 5Department of Neurology, General Cathay Hospital, New Taipei City 22174, Taiwan; 6Department of Pharmacy, Taipei Medical University Hospital, Taipei 11031, TaiwanCorrespondence: Li-Hsuan WangSchool of Pharmacy, College of Pharmacy, Taipei Medical University, 250 Wu-Hsing St., Taipei 11031, TaiwanEmail shiuan@tmu.edu.twObjective: The effect of statins and fibrates on the risk of chronic obstructive pulmonary disease (COPD) remains unclear. The aim of this study was to investigate the effects of statins and fibrates on the risk of COPD in patients with hyperlipidemia.Patients and Methods: This study involved a retrospective cohort with a follow-up period of 6 years. We identified patients who were diagnosed as having hyperlipidemia between 2000 and 2016 from Taiwan’s National Health Insurance Research Database. A Cox proportional hazard model was used to estimate the risk of COPD among different groups. The dose-related effects of statins and fibrates on the risk of COPD were evaluated according to the defined daily dose (DDD).Results: Patients with hyperlipidemia not using statins and fibrates (group II) had a significantly higher risk of COPD compared with their comparison group, with an adjusted hazard ratio (HR) of 1.091 [95% confidence interval (CI): 1.034– 1.152, p < 0.01]. Dose-dependent reduction in the risk of COPD was observed in patients with hyperlipidemia using statins or fibrates compared with patients not using them. Moreover, with an increase in cumulative exposure, a reduced risk of COPD was observed in patients using more than 361 DDDs, with an adjusted HR of 0.474 (95% CI: 0.401– 0.559, p < 0.001). Patients on fibrate monotherapy using more than 541 DDDs were observed to have an adjusted HR of 0.454 (95% CI: 0.226– 0.910, p < 0.05) and those on statin monotherapy with over 361 DDDs were noted to have an adjusted HR of 0.583 (95% CI: 0.459– 0.740, p < 0.001).Conclusion: This study demonstrated that an increase in the cumulative exposure of statins and fibrates significantly reduced the risk of COPD in patients with hyperlipidemia, and the risk reduction appeared to be significantly dose dependent.Keywords: hyperlipidemia, statin, fibrates, chronic obstructive pulmonary disease, cohort study
first_indexed 2024-12-14T09:54:07Z
format Article
id doaj.art-290cb24ab3a34b72b28bb4691ec5d5e1
institution Directory Open Access Journal
issn 1178-2005
language English
last_indexed 2024-12-14T09:54:07Z
publishDate 2020-10-01
publisher Dove Medical Press
record_format Article
series International Journal of COPD
spelling doaj.art-290cb24ab3a34b72b28bb4691ec5d5e12022-12-21T23:07:27ZengDove Medical PressInternational Journal of COPD1178-20052020-10-01Volume 152573258158344Association Between Use of Antihyperlipidemic Agents and Chronic Obstructive Pulmonary Disease in Patients with Hyperlipidemia: A Population-Based Retrospective Cohort StudyLei YFLin HCLin HLUang YSCheng HWWang LHYi-Fen Lei,1,2 Hsiu-Chen Lin,3,4 Hsiu-Li Lin,5 Yow-Sheng Uang,2 Hui-Wen Cheng,2 Li-Hsuan Wang2,6 1Department of Pharmacy, Mackay Memorial Hospital, Taipei 10449, Taiwan; 2School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan; 3Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; 4Department of Clinical Pathology, Taipei Medical University Hospital, Taipei 11031, Taiwan; 5Department of Neurology, General Cathay Hospital, New Taipei City 22174, Taiwan; 6Department of Pharmacy, Taipei Medical University Hospital, Taipei 11031, TaiwanCorrespondence: Li-Hsuan WangSchool of Pharmacy, College of Pharmacy, Taipei Medical University, 250 Wu-Hsing St., Taipei 11031, TaiwanEmail shiuan@tmu.edu.twObjective: The effect of statins and fibrates on the risk of chronic obstructive pulmonary disease (COPD) remains unclear. The aim of this study was to investigate the effects of statins and fibrates on the risk of COPD in patients with hyperlipidemia.Patients and Methods: This study involved a retrospective cohort with a follow-up period of 6 years. We identified patients who were diagnosed as having hyperlipidemia between 2000 and 2016 from Taiwan’s National Health Insurance Research Database. A Cox proportional hazard model was used to estimate the risk of COPD among different groups. The dose-related effects of statins and fibrates on the risk of COPD were evaluated according to the defined daily dose (DDD).Results: Patients with hyperlipidemia not using statins and fibrates (group II) had a significantly higher risk of COPD compared with their comparison group, with an adjusted hazard ratio (HR) of 1.091 [95% confidence interval (CI): 1.034– 1.152, p < 0.01]. Dose-dependent reduction in the risk of COPD was observed in patients with hyperlipidemia using statins or fibrates compared with patients not using them. Moreover, with an increase in cumulative exposure, a reduced risk of COPD was observed in patients using more than 361 DDDs, with an adjusted HR of 0.474 (95% CI: 0.401– 0.559, p < 0.001). Patients on fibrate monotherapy using more than 541 DDDs were observed to have an adjusted HR of 0.454 (95% CI: 0.226– 0.910, p < 0.05) and those on statin monotherapy with over 361 DDDs were noted to have an adjusted HR of 0.583 (95% CI: 0.459– 0.740, p < 0.001).Conclusion: This study demonstrated that an increase in the cumulative exposure of statins and fibrates significantly reduced the risk of COPD in patients with hyperlipidemia, and the risk reduction appeared to be significantly dose dependent.Keywords: hyperlipidemia, statin, fibrates, chronic obstructive pulmonary disease, cohort studyhttps://www.dovepress.com/association-between-use-of-antihyperlipidemic-agents-and-chronic-obstr-peer-reviewed-article-COPDhyperlipidemiastatinfibrateschronic obstructive pulmonary diseasecohort study
spellingShingle Lei YF
Lin HC
Lin HL
Uang YS
Cheng HW
Wang LH
Association Between Use of Antihyperlipidemic Agents and Chronic Obstructive Pulmonary Disease in Patients with Hyperlipidemia: A Population-Based Retrospective Cohort Study
International Journal of COPD
hyperlipidemia
statin
fibrates
chronic obstructive pulmonary disease
cohort study
title Association Between Use of Antihyperlipidemic Agents and Chronic Obstructive Pulmonary Disease in Patients with Hyperlipidemia: A Population-Based Retrospective Cohort Study
title_full Association Between Use of Antihyperlipidemic Agents and Chronic Obstructive Pulmonary Disease in Patients with Hyperlipidemia: A Population-Based Retrospective Cohort Study
title_fullStr Association Between Use of Antihyperlipidemic Agents and Chronic Obstructive Pulmonary Disease in Patients with Hyperlipidemia: A Population-Based Retrospective Cohort Study
title_full_unstemmed Association Between Use of Antihyperlipidemic Agents and Chronic Obstructive Pulmonary Disease in Patients with Hyperlipidemia: A Population-Based Retrospective Cohort Study
title_short Association Between Use of Antihyperlipidemic Agents and Chronic Obstructive Pulmonary Disease in Patients with Hyperlipidemia: A Population-Based Retrospective Cohort Study
title_sort association between use of antihyperlipidemic agents and chronic obstructive pulmonary disease in patients with hyperlipidemia a population based retrospective cohort study
topic hyperlipidemia
statin
fibrates
chronic obstructive pulmonary disease
cohort study
url https://www.dovepress.com/association-between-use-of-antihyperlipidemic-agents-and-chronic-obstr-peer-reviewed-article-COPD
work_keys_str_mv AT leiyf associationbetweenuseofantihyperlipidemicagentsandchronicobstructivepulmonarydiseaseinpatientswithhyperlipidemiaapopulationbasedretrospectivecohortstudy
AT linhc associationbetweenuseofantihyperlipidemicagentsandchronicobstructivepulmonarydiseaseinpatientswithhyperlipidemiaapopulationbasedretrospectivecohortstudy
AT linhl associationbetweenuseofantihyperlipidemicagentsandchronicobstructivepulmonarydiseaseinpatientswithhyperlipidemiaapopulationbasedretrospectivecohortstudy
AT uangys associationbetweenuseofantihyperlipidemicagentsandchronicobstructivepulmonarydiseaseinpatientswithhyperlipidemiaapopulationbasedretrospectivecohortstudy
AT chenghw associationbetweenuseofantihyperlipidemicagentsandchronicobstructivepulmonarydiseaseinpatientswithhyperlipidemiaapopulationbasedretrospectivecohortstudy
AT wanglh associationbetweenuseofantihyperlipidemicagentsandchronicobstructivepulmonarydiseaseinpatientswithhyperlipidemiaapopulationbasedretrospectivecohortstudy