TY - JOUR
T1 - Major Lipids and Future Risk of Pneumonia
T2 - 20-Year Observation of the Atherosclerosis Risk in Communities (ARIC) Study Cohort
AU - Bae, Sangmee Sharon
AU - Chang, L. Cindy
AU - Merkin, Sharon Stein
AU - Elashoff, David
AU - Ishigami, Junichi
AU - Matsushita, Kunihiro
AU - Charles-Schoeman, Christina
N1 - Funding Information:
Funding: CC-S received support from the National Heart, Lung, and Blood Institute ( NHLBI ; R01HL123064 ). This project was supported in part by the UCLA Older American Independence Center (National Institutes of Health [ NIH] P30 AG028748 ) and NIH National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number UL1TR001881 . The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the NHLBI, NIH, Department of Health and Human Services ( HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , HHSN268201700004I ). Funding sources had no participation in study design; in the collection, analysis, and interpretation of data; in writing the report; or in the decision to submit the article for publication.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Circulating lipids have been implicated as important modulators of immune response, and altered lipid levels correlate with the severity of infection. However, long-term prognostic implications of lipid levels regarding future infection risk remain unclear. The current project aims to explore whether baseline lipid levels are associated with risk of future serious infection, measured by hospitalization for pneumonia. Methods: A retrospective analysis was performed in 13,478 participants selected from the Atherosclerosis Risk in Communities (ARIC) study, a large community-based longitudinal cohort in the United States with a median follow-up time of >20 years. First incident of hospitalization for pneumonia was identified through hospital discharge records. Cox proportional hazard models were used to assess the association of baseline major lipid levels (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides) with time to first pneumonia hospitalization. Results: A total of 1969 (14.61%) participants had a pneumonia hospitalization during a median follow-up time of 21.5 years. The hazard ratio (HR) for pneumonia hospitalization was 0.90 (95% confidence interval, 0.87-0.92) for every 10-mg/dL increase in baseline HDL-C, and 1.02 (95% confidence interval, 1.02-1.03) for every 10-mg/dL increase in baseline triglycerides. HDL-C and triglycerides both remained significant predictors of pneumonia hospitalization after multivariable adjustment. Such associations were not seen with baseline LDL-C or total cholesterol levels. Conclusion: Lower baseline HDL-C and higher triglyceride levels were strongly associated with increased risk of long-term pneumonia hospitalization in a large longitudinal US cohort.
AB - Background: Circulating lipids have been implicated as important modulators of immune response, and altered lipid levels correlate with the severity of infection. However, long-term prognostic implications of lipid levels regarding future infection risk remain unclear. The current project aims to explore whether baseline lipid levels are associated with risk of future serious infection, measured by hospitalization for pneumonia. Methods: A retrospective analysis was performed in 13,478 participants selected from the Atherosclerosis Risk in Communities (ARIC) study, a large community-based longitudinal cohort in the United States with a median follow-up time of >20 years. First incident of hospitalization for pneumonia was identified through hospital discharge records. Cox proportional hazard models were used to assess the association of baseline major lipid levels (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides) with time to first pneumonia hospitalization. Results: A total of 1969 (14.61%) participants had a pneumonia hospitalization during a median follow-up time of 21.5 years. The hazard ratio (HR) for pneumonia hospitalization was 0.90 (95% confidence interval, 0.87-0.92) for every 10-mg/dL increase in baseline HDL-C, and 1.02 (95% confidence interval, 1.02-1.03) for every 10-mg/dL increase in baseline triglycerides. HDL-C and triglycerides both remained significant predictors of pneumonia hospitalization after multivariable adjustment. Such associations were not seen with baseline LDL-C or total cholesterol levels. Conclusion: Lower baseline HDL-C and higher triglyceride levels were strongly associated with increased risk of long-term pneumonia hospitalization in a large longitudinal US cohort.
KW - ARIC cohort
KW - Lipids
KW - Observational cohort
KW - Pneumonia
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U2 - 10.1016/j.amjmed.2020.07.022
DO - 10.1016/j.amjmed.2020.07.022
M3 - Article
C2 - 32814017
AN - SCOPUS:85091254912
SN - 0002-9343
VL - 134
SP - 243-251.e2
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 2
ER -