Relationship of hyperlipidemia to comorbidities and lung function in COPD: Results of the COSYCONET cohort

Abstract

Although hyperlipidemia is common in COPD, its relationship to comorbidities, risk factors and lung function in COPD has not been studied in detail. Using the baseline data of the COSYCONET cohort we addressed this question. Data from 1746 COPD patients (GOLD stage 1-4; mean age 64.6 y, mean FEV1%pred 57%) were evaluated, focusing on the comorbidities hyperlipidemia, diabetes and cardiovascular complex (CVC; including arterial hypertension, cardiac failure, ischemic heart disease). Risk factors comprised age, gender, BMI, and packyears of smoking. The results of linear and logistic regression analyses were implemented into a path analysis model describing the multiple relationships between parameters. Hyperlipidemia (prevalence 42.9%) was associated with lower intrathoracic gas volume (ITGV) and higher forced expiratory volume in 1 second (FEV1) when adjusting for its multiple relationships to risk factors and other comorbidities. These findings were robust in various statistical analyses. The associations between comorbidities and risk factors were in accordance with previous findings, thereby underlining the validity of our data. In conclusion, hyperlipidemia was associated with less hyperinflation and airway obstruction in patients with COPD. This surprising result might be due to different COPD phenotypes in these patients or related to effects of medication.

Conflict of interest statement

Competing Interests: Dr. Bals reports grants from Grifols, personal fees from GSK, AstraZeneca, Boehringer Ingelheim, outside the submitted work; Dr. Ficker reports grants from Cosyconet study supported by Bundesministerium fuer Bildung und Forschung BMBF, during the conduct of the study; personal fees from Boehringer, grants, personal fees and non-financial support from CSL-Behring, personal fees from GSK, personal fees from AstraZeneca, personal fees from Roche, personal fees and non-financial support from Novartis, from null, outside the submitted work; Dr. Fähndrich reports grants from CSL Behring, grants from Grifols, grants from AstraZeneca, outside the submitted work; Dr. Holle reports grants from German Federal Ministry of Education and Research (grant number 01GI0882), during the conduct of the study; Dr. Karrasch reports grants from German Federal Ministry of Education and Research (BMBF) with grant number 01GI0882, during the conduct of the study; Dr. Wacker reports grants from German Federal Ministry of Education and Research (grant number 01GI0882), during the conduct of the study;Dr. Vogelmeier reports personal fees from Almirall, personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Chiesi, grants and personal fees from GlaxoSmithKline, grants and personal fees from Grifols, personal fees from Mundipharma, personal fees from Novartis, personal fees from Takeda, personal fees from Cipla, personal fees from Berlin Chemie/Menarini, outside the submitted work; Dr. Jörres reports grants from German Federal Ministry of Education and Research (grant number 01GI0882), during the conduct of the study, as well as Grants from MundiPharma, GSK and Lufthansa that are not related to the present work. The rest of the authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Adjusted effects of hyperlipidemia on lung function.

The figure shows the differences between patients with and without hyperlipidemia for three selected lung function parameters representing airway obstruction, lung volume and alveolar gas exchange. These differences are based on multivariate regression analyses adjusting for age, gender, BMI and packyears, as major confounders some of which were different between groups. The circles represent mean values and the vertical bars 95% confidence intervals, showing that even after adjustment there were significant (p1 and ITGV.

Fig 2. Prevalence of hyperlipidemia versus diabetes and cardiovascular complex.

Diabetes and cardiovascular complex were associated with hyperlipidemia. Significant differences (p

Fig 3. Results of path analysis.

Final path analysis model comprising three layers: risk factors, comorbidities and lung function parameters. The structure only contains relationships which turned out to be statistically significant (p