Lipid lowering drugs prescription and the risk of peripheral neuropathy:: an exploratory case-control study using automated databases
Lipid lowering drugs prescription and the risk of peripheral neuropathy:: an exploratory case-control study using automated databases
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DOI：
10.1136/jech.2003.013409
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发表时间：
2004-12-01
影响因子：
6.3
通讯作者：
Contiero, P
中科院分区：
文献类型：
--
作者：
Corrao, G;Zambon, A;Contiero, P
研究目的：降脂药物虽能有效预防心血管事件的发病率和死亡率，但其不良反应程度尚不清楚。设计：通过多个自动化数据库的链接，进行基于人群的病例对照研究。地点：意大利北部一个省40岁以上的常住人口。研究对象：病例为1998-1999年因周围神经疾病出院的患者。对于每个病例，从符合条件的人中随机选择最多20名对照。研究共纳入2040名患者和36 041名对照。暴露确证：使用处方药数据库评估在指数日期之前一年内的任何时间接触降脂药物。分析：匹配数据的条件Logistic回归模型用于估计与接触他汀类、贝特类和其他降脂药物相关的周围神经病变的风险。主要结果：整体降脂药物(匹配优势比：1.27；95%可信区间：1.05至1.55)、他汀类药物(1.19；1.00~1.40)和贝特(1.49；1.03~2.17)。随着他汀类药物和贝特类药物暴露的增加，风险呈显著的线性增加趋势。结论：他汀类药物和贝特类药物的使用与周围神经病变的风险相关。这项探索性研究的主要目的是信号产生。这需要进一步的研究来评估降脂药物在周围神经病发病中的因果作用。
Study objective: Although lipid lowering drugs are effective in preventing morbidity and mortality from cardiovascular events, the extent of their adverse effects is not clear. This study explored the association between prescription of lipid lowering drugs and the risk of peripheral neuropathy.Design: A population based case-control study was carried out by linkage of several automated databases.Setting: Resident population of a northern Italian Province aged 40 years or more.Participants: Cases were patients discharged for peripheral neuropathy in 1998 - 1999. For each case up to 20 controls were randomly selected among those eligible. Altogether 2040 case patients and 36 041 controls were included in the study.Exposure ascertainment: Prescription drug database was used to assess exposure to lipid lowering drugs at any time in the one year period preceding the index date.Analysis: Conditional logistic regression model for matched data was used to estimate the risk of peripheral neuropathy associated with exposure to statins, fibrates, and other lipid lowering drugs.Main results: Weak but significant effects of lipid lowering drugs as a whole ( matched odds ratio: 1.27; 95% confidence intervals: 1.05 to 1.55), statins ( 1.19; 1.00 to 1.40), and fibrates ( 1.49; 1.03 to 2.17) were observed. Significant linear trends towards increased risk at increased exposure to both statins and fibrates were observed.Conclusions: The use of both statins and fibrates was associated with the risk of peripheral neuropathy. The primary purpose of this exploratory study is signal generation. This requires further investigations to evaluate the causal role of lipid lowering drugs on the onset of peripheral neuropathy.