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Int. J. Environ. Res. Public Health 2015, 12(1), 402-413; doi:10.3390/ijerph120100402

Hyperlipidemia and Statins Affect Neurological Outcome in Lumbar Spine Injury

1
Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan
2
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
3
Department of Pharmacy, National Yang-Ming University Hospital, I-Lan 260, Taiwan
4
School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
5
Department of Medical Research and Education, National Yang-Ming University Hospital, I-Lan 260, Taiwan
6
Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei 112, Taiwan
7
Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
8
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
9
Institute of Pharmacology, National Yang-Ming University, Taipei 112, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 12 November 2014 / Accepted: 30 December 2014 / Published: 5 January 2015
View Full-Text   |   Download PDF [779 KB, uploaded 5 January 2015]   |  

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). View Full-Text
Keywords: statins; hyperlipidemia; lumbar spine injury; national health insurance statins; hyperlipidemia; lumbar spine injury; national health insurance
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Chung, W.-F.; Liu, S.-W.; Chang, P.-Y.; Lin, F.-S.; Chen, L.-F.; Wu, J.-C.; Chen, Y.-C.; Liu, L.; Huang, W.-C.; Cheng, H.; Lo, S.-S. Hyperlipidemia and Statins Affect Neurological Outcome in Lumbar Spine Injury. Int. J. Environ. Res. Public Health 2015, 12, 402-413.

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