From the, Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Department of Information & Statistics, Chungbuk National University, Cheongju, Korea.
J Intern Med. 2020 Dec;288(6):689-698. doi: 10.1111/joim.13134. Epub 2020 Jul 19.
This study aimed to examine the association between statin exposure and dementia risk in individuals with hypercholesterolaemia using data from the NHIS-HEALS database between 2002 and 2015.
Subjects were classified into statin exposure and statin nonexposure groups according to medication possession ratio. Dementia was defined as those with primary diagnostic dementia codes such as F00-F03, G30, G31.1, G31.9 or G31.82. Cox proportional hazards regression models were adopted after stepwise adjustment for confounders to investigate the prospective association between statin exposure and dementia risk.
During the follow-up period (median follow-up 11.7 years), 711 cases of dementia occurred, accounting for 11.5% of the total study population (statin exposure group, 8.2%; statin nonexposure group, 12.9%). Compared to the statin nonexposure group, fully adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) for overall dementia in the statin exposure group were 0.63 (0.43-0.91) and 0.62 (0.50-0.78) in men and women, respectively. Compared to the statin nonexposure group, the HRs (95% CIs) for Alzheimer's disease and related dementia, vascular dementia and other types of dementia in the statin exposure group were 0.54 (0.32-0.91), 2.45 (0.69-8.68) and 0.59 (0.32-1.07), respectively, in men and 0.53 (0.38-0.73), 1.29 (0.42-3.96) and 0.70 (0.51-0.96), respectively, in women.
Hypercholesterolaemic individuals exposed to statin had a lower risk of overall dementia and Alzheimer's disease and related dementia in both sexes, and a lower risk of other types of dementia in women, than subjects who were not exposed to statins.
本研究旨在利用 2002 年至 2015 年 NHIS-HEALS 数据库中的数据，研究他汀类药物暴露与高胆固醇血症患者痴呆风险之间的关系。
根据药物持有率将受试者分为他汀类药物暴露组和他汀类药物非暴露组。痴呆的定义为那些具有原发性诊断痴呆代码的人，如 F00-F03、G30、G31.1、G31.9 或 G31.82。采用 Cox 比例风险回归模型，在逐步调整混杂因素后，对他汀类药物暴露与痴呆风险之间的前瞻性关联进行调查。
在随访期间（中位随访 11.7 年），共发生 711 例痴呆病例，占总研究人群的 11.5%（他汀类药物暴露组 8.2%；他汀类药物非暴露组 12.9%）。与他汀类药物非暴露组相比，他汀类药物暴露组总体痴呆的完全调整后的危险比（95%置信区间）分别为 0.63（0.43-0.91）和 0.62（0.50-0.78），在男性和女性中。与他汀类药物非暴露组相比，他汀类药物暴露组男性和女性阿尔茨海默病及相关痴呆、血管性痴呆和其他类型痴呆的危险比（95%置信区间）分别为 0.54（0.32-0.91）、2.45（0.69-8.68）和 0.59（0.32-1.07）、0.53（0.38-0.73）、1.29（0.42-3.96）和 0.70（0.51-0.96）。
与未使用他汀类药物的患者相比，高胆固醇血症患者使用他汀类药物后，总体痴呆和两性阿尔茨海默病及相关痴呆的风险降低，女性其他类型痴呆的风险降低。
