TY - ABST

T1 - Low-density lipoprotein-cholesterol and risk of chronic obstructive pulmonary disease

T2 - ERS International Congress 2022

AU - Freyberg, J

AU - Afzal, S

AU - Landt, E M

AU - Nordestgaard, B G

AU - Dahl, M

PY - 2022

Y1 - 2022

N2 - Randomized controlled trials investigating the effect of statins on chronic obstructive pulmonary disease (COPD) have found statins to increase lung function and decrease rate of exacerbations in individuals with COPD. However, it is unknown whether this is due to off-target effects or lowering of low-density lipoprotein-cholesterol (LDL-c). We investigated the hypothesis that elevated plasma levels of LDL-c are associated with increased risk of COPD exacerbation and COPD-specific mortality using the Copenhagen General Population Study with outcomes ascertained prospectively through nationwide registries Lower levels of LDL-c were associated with increased risk of spirometric COPD (odds ratio for 1st vs 4th quartile of LDL-c: 1.07 (95 % CI: 1.01-1.14)). In prospective analyses, lower levels of LDL-c were associated with increased risk of COPD exacerbations with hazard ratios of 1.43 (1.21-1.70) for 1st vs 4th quartile of LDL-c, 1.21 (1.03-1.43) for 2nd vs 4th quartile of LDL-c, and 1.01 (0.85-1.20) for 3rd vs 4th quartile of LDL-c (p for trend: 6x10-6). Lower levels of LDL-c at baseline were likewise associated with increased risk of COPD-specific mortality in a stepwise manner (log-rank test p < 0.009). Sensitivity analyses with death as competing risk provided similar results. In conclusion, lower levels of LDL-c were associated with an increased risk of COPD exacerbation and COPD-specific mortality in the Danish general population. These findings might be a result of reverse causation indicating that individuals with severe phenotypes of COPD have lower plasma levels of LDL-c.

AB - Randomized controlled trials investigating the effect of statins on chronic obstructive pulmonary disease (COPD) have found statins to increase lung function and decrease rate of exacerbations in individuals with COPD. However, it is unknown whether this is due to off-target effects or lowering of low-density lipoprotein-cholesterol (LDL-c). We investigated the hypothesis that elevated plasma levels of LDL-c are associated with increased risk of COPD exacerbation and COPD-specific mortality using the Copenhagen General Population Study with outcomes ascertained prospectively through nationwide registries Lower levels of LDL-c were associated with increased risk of spirometric COPD (odds ratio for 1st vs 4th quartile of LDL-c: 1.07 (95 % CI: 1.01-1.14)). In prospective analyses, lower levels of LDL-c were associated with increased risk of COPD exacerbations with hazard ratios of 1.43 (1.21-1.70) for 1st vs 4th quartile of LDL-c, 1.21 (1.03-1.43) for 2nd vs 4th quartile of LDL-c, and 1.01 (0.85-1.20) for 3rd vs 4th quartile of LDL-c (p for trend: 6x10-6). Lower levels of LDL-c at baseline were likewise associated with increased risk of COPD-specific mortality in a stepwise manner (log-rank test p < 0.009). Sensitivity analyses with death as competing risk provided similar results. In conclusion, lower levels of LDL-c were associated with an increased risk of COPD exacerbation and COPD-specific mortality in the Danish general population. These findings might be a result of reverse causation indicating that individuals with severe phenotypes of COPD have lower plasma levels of LDL-c.

U2 - 10.1183/13993003.congress-2022.4513

DO - 10.1183/13993003.congress-2022.4513

M3 - Conference abstract in journal

VL - 60

JO - The European Respiratory Journal

JF - The European Respiratory Journal

SN - 0903-1936

IS - Suppl 66

M1 - 4513

Y2 - 4 September 2022 through 6 September 2022

ER -