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Low-density lipoprotein cholesterol and risk of COPD: Copenhagen General Population Study
BACKGROUND: Randomised controlled trials found that low-density lipoprotein (LDL) cholesterol-lowering statins increase lung function and possibly decrease rate of exacerbations in individuals with COPD. However, it is unknown whether high levels of LDL cholesterol are associated with increased susc...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986766/ https://www.ncbi.nlm.nih.gov/pubmed/36891075 http://dx.doi.org/10.1183/23120541.00496-2022 |
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author | Freyberg, Josefine Landt, Eskild M. Afzal, Shoaib Nordestgaard, Børge G. Dahl, Morten |
author_facet | Freyberg, Josefine Landt, Eskild M. Afzal, Shoaib Nordestgaard, Børge G. Dahl, Morten |
author_sort | Freyberg, Josefine |
collection | PubMed |
description | BACKGROUND: Randomised controlled trials found that low-density lipoprotein (LDL) cholesterol-lowering statins increase lung function and possibly decrease rate of exacerbations in individuals with COPD. However, it is unknown whether high levels of LDL cholesterol are associated with increased susceptibility to COPD. METHODS: We tested the hypothesis that high LDL cholesterol is associated with increased risk of COPD, severe COPD exacerbation and COPD-specific mortality. We examined 107 301 adults from the Copenhagen General Population Study. COPD outcomes were ascertained at baseline and prospectively through nationwide registries. RESULTS: In cross-sectional analysis, low LDL cholesterol was associated with increased risk of COPD (odds ratio for 1st versus 4th quartile: 1.07 (95% CI 1.01–1.14)). Prospectively, low LDL cholesterol was associated with increased risk of COPD exacerbations with hazard ratios of 1.43 (1.21–1.70) for 1st versus 4th quartile, 1.21 (1.03–1.43) for 2nd versus 4th quartile, and 1.01 (0.85–1.20) for 3rd versus 4th quartile of LDL cholesterol (p-value for trend=6×10(−6)). Finally, low LDL cholesterol was likewise associated with increased risk of COPD-specific mortality (log-rank test: p=0.0009). Sensitivity analyses with death as competing risk provided similar results. CONCLUSION: Low LDL cholesterol was associated with increased risks of severe COPD exacerbation and COPD-specific mortality in the Danish general population. As this is opposite of that observed in randomised controlled trials with statins, our findings might be a result of reverse causation indicating that individuals with severe phenotypes of COPD have lower plasma levels of LDL cholesterol due to wasting. |
format | Online Article Text |
id | pubmed-9986766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-99867662023-03-07 Low-density lipoprotein cholesterol and risk of COPD: Copenhagen General Population Study Freyberg, Josefine Landt, Eskild M. Afzal, Shoaib Nordestgaard, Børge G. Dahl, Morten ERJ Open Res Original Research Articles BACKGROUND: Randomised controlled trials found that low-density lipoprotein (LDL) cholesterol-lowering statins increase lung function and possibly decrease rate of exacerbations in individuals with COPD. However, it is unknown whether high levels of LDL cholesterol are associated with increased susceptibility to COPD. METHODS: We tested the hypothesis that high LDL cholesterol is associated with increased risk of COPD, severe COPD exacerbation and COPD-specific mortality. We examined 107 301 adults from the Copenhagen General Population Study. COPD outcomes were ascertained at baseline and prospectively through nationwide registries. RESULTS: In cross-sectional analysis, low LDL cholesterol was associated with increased risk of COPD (odds ratio for 1st versus 4th quartile: 1.07 (95% CI 1.01–1.14)). Prospectively, low LDL cholesterol was associated with increased risk of COPD exacerbations with hazard ratios of 1.43 (1.21–1.70) for 1st versus 4th quartile, 1.21 (1.03–1.43) for 2nd versus 4th quartile, and 1.01 (0.85–1.20) for 3rd versus 4th quartile of LDL cholesterol (p-value for trend=6×10(−6)). Finally, low LDL cholesterol was likewise associated with increased risk of COPD-specific mortality (log-rank test: p=0.0009). Sensitivity analyses with death as competing risk provided similar results. CONCLUSION: Low LDL cholesterol was associated with increased risks of severe COPD exacerbation and COPD-specific mortality in the Danish general population. As this is opposite of that observed in randomised controlled trials with statins, our findings might be a result of reverse causation indicating that individuals with severe phenotypes of COPD have lower plasma levels of LDL cholesterol due to wasting. European Respiratory Society 2023-03-06 /pmc/articles/PMC9986766/ /pubmed/36891075 http://dx.doi.org/10.1183/23120541.00496-2022 Text en Copyright ©The authors 2023 https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org) |
spellingShingle | Original Research Articles Freyberg, Josefine Landt, Eskild M. Afzal, Shoaib Nordestgaard, Børge G. Dahl, Morten Low-density lipoprotein cholesterol and risk of COPD: Copenhagen General Population Study |
title | Low-density lipoprotein cholesterol and risk of COPD: Copenhagen General Population Study |
title_full | Low-density lipoprotein cholesterol and risk of COPD: Copenhagen General Population Study |
title_fullStr | Low-density lipoprotein cholesterol and risk of COPD: Copenhagen General Population Study |
title_full_unstemmed | Low-density lipoprotein cholesterol and risk of COPD: Copenhagen General Population Study |
title_short | Low-density lipoprotein cholesterol and risk of COPD: Copenhagen General Population Study |
title_sort | low-density lipoprotein cholesterol and risk of copd: copenhagen general population study |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986766/ https://www.ncbi.nlm.nih.gov/pubmed/36891075 http://dx.doi.org/10.1183/23120541.00496-2022 |
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