Hyperlipidemia in COPD is associated with decreased incidence of pneumonia and mortality: a nationwide health insurance data-based retrospective cohort study

Abstract

PurposeCOPD is often associated with various comorbidities that may influence its outcomes. Pneumonia, cardiovascular disease (CVD), and cancer are the major causes of death in COPD patients. The objective of this study is to investigate the influence of comorbidities on COPD by using the Taiwan National Health Insurance database.Patients and methodsWe retrospectively analyzed the database in 2006 of one million sampling cohort. Newly diagnosed patients with COPD with a controlled cohort that was matched by age, sex, and Charlson comorbidity index (CCI) were included for analysis.ResultsIn total, 1,491 patients with COPD were included for analysis (61.8% male). Patients with COPD had higher incidences of pneumonia (25.7% vs 10.4%; P<0.0001), CVD (15.1% vs 10.5%; P<0.0001), and mortality rate (26.6% vs 15.8%; P<0.001) compared with the control group in the 4-year follow-up. In patients with COPD, CCI ≥3 have a higher incidence of pneumonia (hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.23–2.09; P<0.0001), CVD (HR 1.73; 95% CI 1.24–2.41; P=0.001), and mortality (HR 1.12; 95% CI 1.12–1.83; P=0.004). Among the major comorbidities of COPD, hyperlipidemia was associated with decreased incidence of pneumonia (HR 0.68; 95% CI 0.5–0.93; P=0.016) and mortality (HR 0.64; 95% CI 0.46–0.90; P=0.009), but was not associated with increased risk of CVD (HR 1.10; 95% CI 0.78–1.55; P=0.588).ConclusionOur results demonstrate that COPD is associated with increased incidence of pneumonia, CVD, and mortality. In patients with COPD, higher CCI is associated with increased incidence of pneumonia, CVD, and mortality. However, COPD with hyperlipidemia is associated with decreased incidence of pneumonia and mortality.

Nomogram Including Neutrophil-to-Lymphocyte Ratio for the Prediction of Stroke-Associated Infections

“…Nevertheless, triglyceride was a protective factor for SAI in our study. This result was consistent with that in a previous retrospective cohort study (n = 1,491), where hyperlipidemia was associated with a decreased incidence of pulmonary infection (39). The participation of adipokines may be one possible explanation.…”

Relationship of hyperlipidemia to comorbidities and lung function in COPD: results of the COSYCONET cohort

“…inflammatory lung disease. Remarkably, patients with COPD and hyperlipidemia appear to have a better outcome in pneumonia-related exacerbations and mortality [4,5]. It may also be noteworthy that several studies described an anti-inflammatory action of simvastatin [30], an improved FEV 1 in patients undergoing this therapy [31] a protective effect against the development of emphysema [32], in accordance with the, on average, better FEV 1 and KCO in our patients (Table 1).…”

Relationship of hyperlipidemia to comorbidities and lung function in COPD: Results of the COSYCONET cohort

“…Although most comorbidities are associated with increased mortality, retrospective analyses revealed a decreased incidence of pneumonia and reduced mortality in COPD patients with hyperlipidemia [4, 5]. Thus the role of hyperlipidemia remains unclear and its relationship to other comorbidities, risk factors and pulmonary function has to be studied in more detail.…”

“…Hyperlipidemia is a major risk factor for cardiovascular diseases which are common comorbidities in patients with chronic obstructive pulmonary disease (COPD) [ 1 ], but there are only limited studies on its role in COPD itself [ 2 , 3 ]. Although most comorbidities are associated with increased mortality, retrospective analyses revealed a decreased incidence of pneumonia and reduced mortality in COPD patients with hyperlipidemia [ 4 , 5 ]. Thus the role of hyperlipidemia remains unclear and its relationship to other comorbidities, risk factors and pulmonary function has to be studied in more detail.…”