Major Lipids and Future Risk of Pneumonia: 20-Year Observation of the Atherosclerosis Risk in Communities (ARIC) Study Cohort |
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| Authors: | Sangmee Sharon Bae L Cindy Chang Sharon Stein Merkin David Elashoff Junichi Ishigami Kunihiro Matsushita Christina Charles-Schoeman |
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| Institution: | 1. Division of Rheumatology;2. Cancer Prevention & Control Res/FSPH & JCCC;3. Division of Geriatrics;4. Division of General Internal Medicine and Health Services Research, University of California Los Angeles;5. Johns Hopkins Bloomberg School of Public Health and Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Md;1. Pulmonary Medicine, Providence Health System, Seattle, Wash;2. Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif;3. Pulmonary and Critical Care Medicine, University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester;4. University of Massachusetts Medical School and Graduate School of Nursing, Worcester;5. Pulmonary Medicine, Intermountain Healthcare and University of Utah School of Medicine, Murray;6. University College London Hospitals NHS Foundation Trust and Cardiometabolic Programme-NIHR UCLH/UCL BRC, London, UK;1. Department of Medicine, Oregon Health & Science University, Portland, OR;2. Department of Medicine, Division of Infectious Diseases, Oregon Health & Science University, Portland, OR;3. Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR;4. Department of Medicine, VA Portland Healthcare System; Portland, OR |
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| Abstract: | BackgroundCirculating 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.MethodsA 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.ResultsA 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.ConclusionLower baseline HDL-C and higher triglyceride levels were strongly associated with increased risk of long-term pneumonia hospitalization in a large longitudinal US cohort. |
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| Keywords: | ARIC cohort Lipids Observational cohort Pneumonia |
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