title: Advanced chronic obstructive pulmonary disease is associated with high levels of high-density lipoprotein cholesterol.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is an inflammatory systemic disease associated with numerous extrapulmonary manifestations. Amongst these is an increased risk for cardiovascular disease. The mechanisms for this association remain unclear. We sought to examine lipid trends in a well-characterized cohort of patients with severe COPD.
  
  
  METHODS
  We conducted a retrospective prospective analysis of 126 consecutive individuals evaluated for lung transplantation with a diagnosis of COPD in whom lipid values were available. Observed lipid values were compared with a reference population without severe COPD.
  
  
  RESULTS
  Compared with the reference population, mean low-density lipoprotein cholesterol (LDL-C) levels were slightly reduced at 108 ± 44 vs 117 ± 29.5 mg/dl (p = 0.02) in men but were no different in women. Mean high-density lipoprotein cholesterol (HDL-C) levels were significantly elevated at 62 ± 24 vs 45 ± 12 mg/dl (p < 0.0001) in men and at 83 ± 27 vs 59 ± 16 mg/dl in women (p < 0.0001). Prednisone use correlated with higher HDL-C levels but did not fully explain the extent of elevation. Angiographically proven coronary artery disease was found in 61% of individuals and was unrelated to HDL-C levels.
  
  
  CONCLUSIONS
  Severe COPD is associated with increased levels of HDL-C, which is partially attributable to oral steroid use. HDL-C in this population is not associated with reduced risk of angiographically proven coronary artery disease.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. rreed@medicine.umaryland.edu
authors.forename: Robert M
authors.initials: RM
authors.lastname: Reed
authors.forename: Aldo
authors.initials: A
authors.lastname: Iacono
authors.forename: Andrew
authors.initials: A
authors.lastname: DeFilippis
authors.forename: Michael
authors.initials: M
authors.lastname: Eberlein
authors.forename: Reda E
authors.initials: RE
authors.lastname: Girgis
authors.forename: Steven
authors.initials: S
authors.lastname: Jones
mesh_terms: D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood* / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000494:pharmacology; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005938:Glucocorticoids; D011241:Prednisone