Jang Sarang, Choi Hyo Geun, Kwon Mi Jung, Kim Ji Hee, Kim Joo-Hee, Kim So Young
Department of Public Health, Sahmyook University, Seoul 01795, Republic of Korea.
Mdanalytics, Seoul 06349, Republic of Korea.
Pharmaceuticals (Basel). 2023 Jun 19;16(6):900. doi: 10.3390/ph16060900.
The present study evaluated the association of long-term statin use with the diagnosis and mortality of esophageal cancer in a Korean population. The Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2019 was enrolled. Esophageal cancer patients were matched with control participants for demographic variables. The statin prescription histories were collected and grouped into <180 days, 180 to 545 days, and >545 days of duration. Propensity score overlap weighting was applied to minimize the bias between the esophageal cancer and control groups. The odds ratios (ORs) of the duration of statin use for esophageal cancer were analyzed using propensity score overlap weighted multivariable logistic regression analysis. The esophageal cancer group was classified as dead and surviving patients, and the ORs of the duration of statin use for the mortality of esophageal cancer were analyzed in an identical manner. Secondary analyses were conducted according to comorbid factors. Patients with esophageal cancer did not show lower odds for the duration of statin prescription in the overall study population (OR = 1.30, 95% CI = 1.03-1.65, = 0.027 for 180 to 545 days and OR = 1.29, 95% CI = 1.08-1.55, = 0.006 for >545 days). Subgroups of nonsmokers, past and current smokers, alcohol consumption ≥ 1 time a week, SBP < 140 mmHg and DBP < 90 mmHg, fasting blood glucose ≥ 100 mg/dL, total cholesterol ≥ 200 mg/dL, CCI score = 0, and nondyslipidemia history demonstrated low odds for the duration of statin prescription. Both types of statins, hydrophilic and lipophilic statins, were not related to a lower rate of esophageal cancer. The mortality of esophageal cancer was not associated with the duration of statin prescription. A subgroup with total cholesterol ≥ 200 mg/dL showed lower odds of statin prescription for mortality of esophageal cancer. The duration of statin prescription was not related to a lower rate or mortality of esophageal cancer in the adult Korean population.
本研究评估了韩国人群中长期使用他汀类药物与食管癌诊断及死亡率之间的关联。纳入了2002年至2019年韩国国民健康保险服务健康筛查队列。将食管癌患者与对照参与者按人口统计学变量进行匹配。收集他汀类药物处方史并按使用时长分为<180天、180至545天和>545天。应用倾向得分重叠加权法以最小化食管癌组与对照组之间的偏差。使用倾向得分重叠加权多变量逻辑回归分析来分析他汀类药物使用时长与食管癌的比值比(OR)。将食管癌组分为死亡和存活患者,并以相同方式分析他汀类药物使用时长与食管癌死亡率的OR。根据合并症因素进行了二次分析。在总体研究人群中,食管癌患者的他汀类药物处方时长的OR并未降低(180至545天:OR = 1.30,95%可信区间 = 1.03 - 1.65,P = 0.027;>545天:OR = 1.29,95%可信区间 = 1.08 - 1.55,P = 0.006)。非吸烟者、既往和当前吸烟者、每周饮酒≥1次、收缩压<140 mmHg和舒张压<90 mmHg、空腹血糖≥100 mg/dL、总胆固醇≥200 mg/dL、CCI评分 = 0以及无血脂异常病史的亚组显示他汀类药物处方时长的OR较低。亲水性和脂溶性他汀类药物这两种类型均与较低的食管癌发生率无关。食管癌死亡率与他汀类药物处方时长无关。总胆固醇≥200 mg/dL的亚组显示他汀类药物处方用于食管癌死亡率的OR较低。在成年韩国人群中,他汀类药物处方时长与较低的食管癌发生率或死亡率无关。