既往他汀类药物使用对成年人群慢性阻塞性肺疾病患病率及病情加重的影响
The Influence of Prior Statin Use on the Prevalence and Exacerbation of Chronic Obstructive Pulmonary Disease in an Adult Population.
作者信息
Kim Joo-Hee, Choi Hyo Geun, Kwon Mi Jung, Kim Ji Hee, Park Ji-Young, Hwang Yong Il, Jang Seung Hun, Jung Ki-Suck
机构信息
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
出版信息
Front Med (Lausanne). 2022 Mar 24;9:842948. doi: 10.3389/fmed.2022.842948. eCollection 2022.
BACKGROUND
Statins have anti-inflammatory and antioxidant properties, and previous studies have reported the positive effects of statins on chronic obstructive pulmonary disease (COPD) outcomes. However, the effects of statins on the development and acute exacerbations of COPD remain unclear. Therefore, this study aimed to assess the relation between statin use and COPD occurrence in all participants and the link between statin use and COPD acute exacerbations in participants with COPD.
METHODS
This case-control study comprised 26,875 COPD participants and 107,500 control participants who were 1:4 matched from the Korean National Health Insurance Service-Health Screening Cohort. Conditional logistic regression was used to evaluate the probability of COPD occurrence associated with previous statin use. In addition, unconditional logistic regression was employed to assess the risk of exacerbations related to statin use among COPD participants. These relations were estimated in subgroup analysis according to statin type (lipophilic vs. hydrophilic).
RESULTS
The association between previous statin use and the occurrence of COPD did not reach statistical significance in the overall population (adjusted odds ratio [aOR] = 0.96, 95% confidence interval [CI] = 0.93-1.00, = 0.059). However, statin use decreased the probability of exacerbations in participants with COPD (aOR = 0.79, 95% CI = 0.74-0.85, < 0.001). Lipophilic statins decreased the probability of exacerbations, whereas hydrophilic statins were not associated with a decreased likelihood of exacerbations (aOR = 0.78, 95% CI = 0.72-0.84, < 0.001 for lipophilic statins; aOR = 0.89, 95% CI = 0.78-1.02, = 0.102 for hydrophilic statins).
DISCUSSION
Statin use was not associated with the occurrence of COPD in the adult population. However, statin use was associated with a reduced probability of exacerbations in participants with COPD, with a greater risk reduction with lipophilic statin use.
背景
他汀类药物具有抗炎和抗氧化特性，先前的研究报道了他汀类药物对慢性阻塞性肺疾病（COPD）预后的积极影响。然而，他汀类药物对COPD发生和急性加重的影响仍不明确。因此，本研究旨在评估所有参与者中他汀类药物使用与COPD发生之间的关系，以及COPD参与者中他汀类药物使用与COPD急性加重之间的联系。
方法
本病例对照研究包括26875名COPD参与者和107500名对照参与者，他们从韩国国民健康保险服务-健康筛查队列中按1:4匹配。采用条件逻辑回归评估既往使用他汀类药物与COPD发生的相关概率。此外，采用无条件逻辑回归评估COPD参与者中与他汀类药物使用相关的加重风险。根据他汀类药物类型（亲脂性与亲水性）在亚组分析中估计这些关系。
结果
在总体人群中，既往使用他汀类药物与COPD发生之间的关联未达到统计学显著性（调整优势比[aOR]=0.96，95%置信区间[CI]=0.93-1.00，P=0.059）。然而，使用他汀类药物降低了COPD参与者加重的概率（aOR=0.79，95%CI=0.74-0.85，P<0.001）。亲脂性他汀类药物降低了加重的概率，而亲水性他汀类药物与加重可能性降低无关（亲脂性他汀类药物aOR=0.
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