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Association between Previous Statin Use and Alzheimer's Disease: A Nested Case-Control Study Using a National Health Screening Cohort.

ABSTRACT: A number of studies report the incidence of Alzheimer's disease (AD) in patients taking statins, but the results are inconsistent. (1) Background: The present study investigated the cross-sectional association between previous statin use and the risk of AD development in Korean residents. (2) Methods: We used the Korean National Health Insurance Service-National Sample Cohort; 17,172 AD patients were matched by age, gender, income, and region of residence with 68,688 control participants at a ratio of 1:4. We used a multiple conditional logistic regression model to analyse the association between the number of days of statin use and AD occurrence. Further analyses were performed to identify whether this association is maintained for different ages, genders, socioeconomic status groups, and covariates. (3) Results: The odds ratio, which was adjusted for potential confounders, for the days of statin use per year in the AD group compared to the control group was 0.95 (95% confidence interval = 0.92-0.98; p = 0.003). The number of days of statin use in the AD group was significantly smaller in the subgroups of non-smokers and individuals with normal weight, alcohol consumption less than once a week, total cholesterol level below 200 mg/dL, systolic blood pressure below 140, diastolic blood pressure below 90, and fasting blood glucose below 100 mg/dL. (4) Conclusions: Our results suggest that statin use prevents the occurrence of AD. The effects of statin use in preventing AD may be greater in individuals at relatively low risk.

SUBMITTER: Kim JH

PROVIDER: S-EPMC8003839 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Association between Osteoporosis and Previous Statin Use: A Nested Case-Control Study.

Project description:The relationship between statin use and osteoporosis is controversial; therefore, this study aimed to investigate this association. The ≥40-year-old population of the Korean National Health Insurance Service Health Screening Cohort was enrolled. The 68,592 osteoporosis patients were matched 1:1 with control participants for age, sex, income, and region of residence using propensity score matching. The histories of statin use for two years before the diagnosis of osteoporosis (index date) in the osteoporosis and control groups were compared using conditional/unconditional logistic regression. An increased number of days of statin use was not associated with osteoporosis (adjusted OR (aOR) = 0.97, 95% confidence interval (95% CI) = 0.94-1.00, p = 0.052). In the subgroup analyses, a large number of days of statin use was related to a reduced rate of osteoporosis in the <60-year-old female group, while the opposite was true in the ≥60-year-old female group. Both lipophilic and hydrophilic statins were related to a decreased rate of osteoporosis in the <60-year-old female group. Lipophilic statins, but not hydrophilic statins, were associated with an increased rate of osteoporosis in the ≥60-year-old female group. Statin use showed different associations in middle-aged and elderly women.

| S-EPMC8620647 | biostudies-literature

Association between Statin Use and Gastric Cancer: A Nested Case-Control Study Using a National Health Screening Cohort in Korea.

Project description:Concerns about the hazards of statins on the development and mortality of stomach cancers remain controversial. Here, we investigated the likelihood of incident gastric cancers and related mortality depending on statin exposure, statin type, and the duration of use. This nested case-control-designed study was composed of 8798 patients who were diagnosed with gastric cancer and matched with 35,192 controls at a 1:4 ratio based on propensity scores of age, sex, residential area, and income from the Korean National Health Insurance Service-Health Screening Cohort database (2002-2015). Propensity score overlap weighting was adjusted to balance the baseline covariates. Overlap propensity score-weighted logistic regression analyses were assessed to determine associations of the prior use of statins (any statin, hydrophilic statins vs. lipophilic statins) with incident gastric cancer and its mortality depending on the medication duration (<180 days, 180-545 days, and >545 days) after adjusting for multiple covariates. After adjustment, the use of any statin, hydrophilic statins, or lipophilic statins showed significant associations with lower odds for incident stomach cancer when used for a short-term period (180-545 days) (OR = 0.88, 95% CI = 0.81-0.86, p = 0.002; OR = 0.78, 95% CI = 0.66-0.92, p = 0.004; and OR = 0.91, 95% CI = 0.84-0.99, p = 0.039, respectively) compared to the control group. Hydrophilic statin use for 180-545 days was associated with 53% lower overall mortality (OR = 0.47; 95% CI = 0.29-0.77). In subgroup analyses, beneficial effects on both cancer development and mortality persisted in patients ≥65 years old, patients with normal blood pressure, and patients with high fasting glucose levels. There were no such associations with long-term statin use (>545 days). Thus, the current nationwide cohort study suggests that prior short-term statin use may have anti-gastric cancer benefits in elderly patients with hyperglycemia.

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Associations Between Asthma Diagnosis/Asthma Exacerbation and Previous Proton-Pump Inhibitor use: A Nested Case-Control Study Using a National Health Screening Cohort.

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Association between Tooth Loss and Alzheimer's Disease in a Nested Case-Control Study Based on a National Health Screening Cohort.

Project description:Reports on the possible risks for Alzheimer's disease (AD) have included tooth loss as a potential risk factor. However, there are few studies addressing the association between tooth loss and AD in a large sample of participants. Accordingly, the objective of the current study was to explore the association of tooth loss with the development of AD in Korean adults. This nested case-control study, which is an analysis utilizing the data of the Korean National Health Insurance Service Health Screening Cohort study, randomly selected AD and control participants among Korean residents aged ≥60 years. The association between the number of missing teeth and AD occurrence was examined using a logistic regression model. Participants' lifestyle factors (smoking and alcohol consumption) and various medical conditions and comorbidities were included as covariates. The mean number of missing teeth was 2.94 in the AD group and 2.59 in the control group. After adjusting for covariates, tooth loss was significantly associated with AD, with an odds ratio (OR) (per 16 missing teeth) of 1.15 (95% confidence interval (CI) = 1.07-1.23, p < 0.001). Tooth loss remained consistently significantly associated with an increased risk of AD for both upper and lower tooth loss. A higher number of missing teeth was related to a higher probability of AD occurrence in an elderly Korean population. Efforts to manage tooth loss could be a possible approach to prevent AD.

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Evaluation of the relationship between previous statin use and thyroid cancer using Korean National Health Insurance Service-Health Screening Cohort data.

Project description:The association of thyroid cancer with statin use is controversial. This study aimed to investigate the association of previous statin use with thyroid cancer in the ≥ 40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort. The 5501 patients in the thyroid cancer group were matched with the 22,004 patients in the non-thyroid cancer group for age, sex, income, and region of residence. Previous statin use during the 2 years before the diagnosis of thyroid cancer was examined. The odds ratios (ORs) with 95% confidence intervals (CIs) of previous statin use for thyroid cancer were estimated using conditional logistic regression analyses. Additionally, subgroup analyses were conducted. The thyroid cancer group showed more days of previous statin use than the non-thyroid cancer group (72.3, standard deviation [SD] = 181.2 days vs. 64.3, SD = 174.4 days, P = 0.003). Although the odds of previous statin use for thyroid cancer were high in the crude model (OR = 1.10, 95% CI 1.04-1.17, P = 0.002), they were low in the fully adjusted model (OR = 0.89, 95% CI 0.82-0.95, P = 0.001). According to age and sex subgroups, the younger (< 60 years old) male group showed lower odds for thyroid cancer according to previous statin use (adjusted OR = 0.70, 95% CI 0.55-0.88, P = 0.003), but this finding was not observed in other subgroups of older men or in any groups of women. Thyroid cancer was negatively associated with statin use in the previous 2 years in the adjusted model.

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Association between the Use of Proton Pump Inhibitors and Cardiovascular Diseases: A Nested Case-Control Study Using a National Health Screening Cohort.

Project description:We investigated the association of proton pump inhibitor (PPI) use with the risk of stroke and ischemic heart disease (IHD). The Korean National Health Insurance Service-Health Screening cohort from 2002 to 2003, the participants of which were followed up until 2019, was used. In study I, 45,905 participants who were diagnosed with stroke were matched with 91,810 control I participants. The history of PPI medication was examined. In study II, 40,928 participants who were diagnosed with IHD were matched with 81,856 control II participants. In both study I and study II, the previous history of PPI medication was examined. A propensity score overlap-weighted multivariable logistic regression analysis was conducted to estimate the overlap-weighted odds ratios (ORs) of PPI use for stroke (study I) and IHD (study II). Current PPI use was linked with higher odds for stroke in study I. The odds for stroke were higher in groups with a longer duration of PPI use (OR = 0.96 [95% CI = 0.92-1.00] < 1.55 [1.50-1.61] < 1.62 [1.57-1.68] for < 30 days, 30 to 180 days, and ≥180 days of PPI use). Previous PPI use was linked with higher odds for IHD in study II. The odds for stroke were higher in groups with a longer duration of PPI use (OR = 1.13 [95% CI = 1.08-1.18] < 2.12 [2.04-2.21] < 2.60 [2.51-2.69] for <30 days, 30 to 180 days, and ≥180 days of PPI use). Current PPI medication is associated with a high risk of stroke and IHD. A longer duration of PPI medication was related to a higher risk of stroke and IHD. However, a prior history of PPI medication was not linked with a high risk of stroke or IHD.

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The Association between Anemia and Parkinson's Disease: A Nested Case-Control Study Using a National Health Screening Cohort.

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| S-EPMC8152756 | biostudies-literature

Association between Osteoporosis and Low Hemoglobin Levels: A Nested Case-Control Study Using a National Health Screening Cohort.

Project description:An association between anemia and an increased risk of osteoporosis has been suggested. The goal of this study was to estimate the association of hemoglobin (Hb) level with osteoporosis. A total of 69,760 osteoporosis patients aged ≥ 40 years old from the Korean National Health Insurance Service Health Screening Cohort were enrolled. From an identical cohort database, 69,760 comparison participants were randomly selected. Hb levels before the onset of osteoporosis were evaluated. The association of Hb level with osteoporosis was analyzed using a conditional logistic regression model adjusted for obesity, smoking status, alcohol consumption, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, and the Charlson comorbidity index score. Fifteen percent of the osteoporosis group and 14.17% of the comparison group had anemia. The Hb level was associated with 0.98-fold lower odds for osteoporosis (95% confidence intervals = 0.97-0.99, p < 0.001). A low Hb level was associated with a high risk of osteoporosis in the adult population. There was a consistent association between a low Hb level and osteoporosis in patients with comorbidities.

| S-EPMC8394089 | biostudies-literature

Healthcare utilisation prior to suicide in persons with alcohol use disorder: national cohort and nested case-control study.

Project description:BackgroundAlcohol use disorder (AUD) is common and associated with increased risk of suicide.AimsTo examine healthcare utilisation prior to suicide in persons with AUD in a large population-based cohort, which may reveal opportunities for prevention.MethodA national cohort study was conducted of 6 947 191 adults in Sweden in 2002, including 256 647 (3.7%) with AUD, with follow-up for suicide through 2015. A nested case-control design examined healthcare utilisation among people with AUD who died by suicide and 10:1 age- and gender-matched controls.ResultsIn 86.7 million person-years of follow-up, 15 662 (0.2%) persons died by suicide, including 2601 (1.0%) with AUD. Unadjusted and adjusted relative risks for suicide associated with AUD were 8.15 (95% CI 7.86-8.46) and 2.22 (95% CI 2.11-2.34). Of the people with AUD who died by suicide, 39.7% and 75.6% had a healthcare encounter <2 weeks or <3 months before the index date respectively, compared with 6.3% and 25.4% of controls (adjusted prevalence ratio (PR) and difference (PD), <2 weeks: PR = 3.86, 95% CI 3.50-4.25, PD = 26.4, 95% CI 24.2-28.6; <3 months: PR = 2.03, 95% CI 1.94-2.12, PD = 34.9, 95% CI 32.6-37.1). AUD accounted for more healthcare encounters within 2 weeks of suicide among men than women (P = 0.01). Of last encounters, 48.1% were in primary care and 28.9% were in specialty out-patient clinics, mostly for non-psychiatric diagnoses.ConclusionsSuicide among persons with AUD is often shortly preceded by healthcare encounters in primary care or specialty out-patient clinics. Encounters in these settings are important opportunities to identify active suicidality and intervene accordingly in patients with AUD.

| S-EPMC7704805 | biostudies-literature

Bell's palsy and obesity, alcohol consumption and smoking: A nested case-control study using a national health screening cohort.

Project description:The aim of this study was to investigate the association of body mass index (BMI), alcohol consumption, and smoking status with the occurrence of Bell's palsy. The Korean National Health Insurance Service-Health Screening Cohort of a ≥ 40-year-old population from 2000-2003 was used. A total of 5,632 Bell's palsy participants were matched with 22,528 control participants in terms of age, sex, income, region of residence, and past medical histories of hypertension, diabetes, and dyslipidemia. Bell's palsy was classified by a history of ≥2 diagnoses with ICD-10 code (G510) and steroid treatment. BMI (kg/m2) was classified as <18.5 (underweight), ≥18.5 to <23 (normal), ≥23 to <25 (overweight), ≥25 to <30 (obese I), and ≥30 (obese II). Alcohol consumption was divided into non-drinkers and those who drank 2-3 times a month, 1-2 times a week, and ≥3 times a week. Smoking status was categorized as current smokers, past smokers, and non-smokers. The odds of obesity, alcohol consumption, and smoking with Bell's palsy were analyzed using logistic regression analysis. BMI showed proportionally positive associations with Bell's palsy (adjusted OR [95% CI] = 0.61 [0.47-0.79] for underweight, 1.16 [1.08-1.26] for normal, 1.24 [1.15-1.33] for obese I, and 1.61 [1.38-1.88] for obese II, P < 0.001). The odds of alcohol consumption with Bell's palsy were 0.90 (95% confidence interval [CI] = 0.82-0.99) for 2-3 times a month, 0.77 (95% CI = 0.69-0.85) for 1-2 times a week, and 0.79 (95% CI = 0.71-0.88) for ≥3 times a week compared to nondrinkers (P < 0.001). Smoking did not show a relationship with the occurrence of Bell's palsy. Obesity was related to the risk of Bell's palsy in the population over 40 years old. On the other hand, alcohol consumption was negatively associated with the occurrence of Bell's palsy.

| S-EPMC7060281 | biostudies-literature

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