title: Hyperlipidemia and statins affect neurological outcome in lumbar spine injury.
abstract: The disabling pathophysiologic effects of lipid and neuroprotective effects of statins have recently been demonstrated for acute spinal cord injuries in animal models. This large scale population-based study aimed to investigate the effect hyperlipidemia and the use of statins in patients with lumbar spine injury. The National Health Insurance Research Database of Taiwan was used to identify patients with lumbar spine injury. A total of 2844 patients were grouped into three: no hyperlipidemia, hyperlipidemia using low-dose of statins (≤90 of the defined daily dosage (DDD)), and severe hyperlipidemia using high-dose of statins (>90 DDD). A Cox multiple regression model was used to compare the incidence rates of disability among the three groups. The results showed that patients with hyperlipidemia appeared a higher risk of permanent disability (adjusted HR = 1.38, p = 0.28). In subgroup analysis, patients with severe hyperlipidemia had a higher risk of disability (adjusted HR = 3.1, p < 0.004), whereas hyperlipidemia using low-dose statins had a similar risk of permanently disability (adjusted HR = 0.83, p = 0.661). Hyperlipidemia adversely affected the neurological outcomes of lumbar spinal injury. Statins may have the potential to reverse this higher risk of disability. However, this beneficiary effect of statins only existed in patients using a lower dose (≤90 DDD).
authors.affiliation: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan. wolfchung2001@yahoo.com.tw.
authors.forename: Wu-Fu
authors.initials: WF
authors.lastname: Chung
authors.affiliation: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan. shihweiliu123@gmail.com.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan. acidbummer@gmail.com.
authors.forename: Peng-Yuan
authors.initials: PY
authors.lastname: Chang
authors.affiliation: Department of Pharmacy, National Yang-Ming University Hospital, I-Lan 260, Taiwan. fengshulin168@gmail.com.
authors.forename: Feng-Shu
authors.initials: FS
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan. sslo@ymuh.ym.edu.tw.
authors.forename: Li-Fu
authors.initials: LF
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan. sslo@ymuh.ym.edu.tw.
authors.forename: Jau-Ching
authors.initials: JC
authors.lastname: Wu
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei 112, Taiwan. yuchn.chen@gmail.com.
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan. laurajl@gmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan. sslo@ymuh.ym.edu.tw.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan. sslo@ymuh.ym.edu.tw.
authors.forename: Henrich
authors.initials: H
authors.lastname: Cheng
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei 112, Taiwan. sslo@ymuh.ym.edu.tw.
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Lo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000188:drug therapy*; D013624:Taiwan / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018696:Neuroprotective Agents