{"title":"使用红麴治疗的高脂血症患者发生肝硬化的实际风险和结局:一项回顾性队列研究","authors":"Chuen-Chau Chang, Chun-Chieh Yeh, Cheng Tiong, Mao-Feng Sun, Jaung-Geng Lin, Yih-Giun Cherng, Ta-Liang Chen, Chien-Chang Liao","doi":"10.2147/jmdh.s466696","DOIUrl":null,"url":null,"abstract":"<strong>Objective:</strong> Sustained hyperlipidemia contributes to fatty liver and liver cirrhosis. Red yeast rice (RYR) effectively improved the lipid profile; however, the effects of RYR on the risk of incident liver cirrhosis remain to be elucidated. We aimed to evaluate the beneficial effects of RYR use on the risk and outcome of liver cirrhosis.<br/><strong>Patients and methods:</strong> We identified 156,587 adults who had newly diagnosed hyperlipidemia in 2010– 2016 from health insurance data in this retrospective cohort study. Using propensity score matching, we selected 34,367 patients who used RYR and 34,367 patients who used lovastatin. Events of incident liver cirrhosis that occurred in the two cohorts during the follow-up period of 2010– 2019 were identified. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (Cis) for liver cirrhosis risk associated with RYR use in the multiple Cox proportional hazard model.<br/><strong>Results:</strong> Compared with patients who used lovastatin, patients who used RYR had a decreased risk of liver cirrhosis (HR 0.60, 95% CI 0.57– 0.63), and this association was significant in various subgroups. A biological gradient relationship between the frequency of RYR use and decreased liver cirrhosis was observed (p for trend < 0.0001). Reduced postcirrhosis jaundice (HR 0.56, 95% CI 0.43– 0.72), ascites (HR 0.37, 95% CI 0.28– 0.50), hepatic coma (HR 0.36, 95% CI 0.26– 0.50), and mortality (HR 0.48, 95% CI 0.38– 0.61) were also associated with RYR use.<br/><strong>Conclusion:</strong> We demonstrated the beneficial effects of RYR use on the risk and outcome of liver cirrhosis; however, the lack of compliance data should be considered. However, our study did not infer causality or claim the superiority of RYR over lovastatin.<br/><br/><strong>Keywords:</strong> hyperlipidemia, liver cirrhosis, lovastatin, outcome, red yeast rice, risk<br/>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Real-World Risk and Outcome of Liver Cirrhosis in Patients with Hyperlipidemia Treated with Red Yeast Rice: A Retrospective Cohort Study\",\"authors\":\"Chuen-Chau Chang, Chun-Chieh Yeh, Cheng Tiong, Mao-Feng Sun, Jaung-Geng Lin, Yih-Giun Cherng, Ta-Liang Chen, Chien-Chang Liao\",\"doi\":\"10.2147/jmdh.s466696\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<strong>Objective:</strong> Sustained hyperlipidemia contributes to fatty liver and liver cirrhosis. Red yeast rice (RYR) effectively improved the lipid profile; however, the effects of RYR on the risk of incident liver cirrhosis remain to be elucidated. We aimed to evaluate the beneficial effects of RYR use on the risk and outcome of liver cirrhosis.<br/><strong>Patients and methods:</strong> We identified 156,587 adults who had newly diagnosed hyperlipidemia in 2010– 2016 from health insurance data in this retrospective cohort study. Using propensity score matching, we selected 34,367 patients who used RYR and 34,367 patients who used lovastatin. Events of incident liver cirrhosis that occurred in the two cohorts during the follow-up period of 2010– 2019 were identified. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (Cis) for liver cirrhosis risk associated with RYR use in the multiple Cox proportional hazard model.<br/><strong>Results:</strong> Compared with patients who used lovastatin, patients who used RYR had a decreased risk of liver cirrhosis (HR 0.60, 95% CI 0.57– 0.63), and this association was significant in various subgroups. A biological gradient relationship between the frequency of RYR use and decreased liver cirrhosis was observed (p for trend < 0.0001). Reduced postcirrhosis jaundice (HR 0.56, 95% CI 0.43– 0.72), ascites (HR 0.37, 95% CI 0.28– 0.50), hepatic coma (HR 0.36, 95% CI 0.26– 0.50), and mortality (HR 0.48, 95% CI 0.38– 0.61) were also associated with RYR use.<br/><strong>Conclusion:</strong> We demonstrated the beneficial effects of RYR use on the risk and outcome of liver cirrhosis; however, the lack of compliance data should be considered. However, our study did not infer causality or claim the superiority of RYR over lovastatin.<br/><br/><strong>Keywords:</strong> hyperlipidemia, liver cirrhosis, lovastatin, outcome, red yeast rice, risk<br/>\",\"PeriodicalId\":16357,\"journal\":{\"name\":\"Journal of Multidisciplinary Healthcare\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Multidisciplinary Healthcare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/jmdh.s466696\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/jmdh.s466696","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
目的:持续的高脂血症会导致脂肪肝和肝硬化。红酵母米(RYR)能有效改善血脂状况;然而,红酵母米对肝硬化发病风险的影响仍有待阐明。我们的目的是评估服用红酵母米对肝硬化风险和结果的有益影响:在这项回顾性队列研究中,我们从医疗保险数据中确定了156587名在2010-2016年间新诊断出高脂血症的成年人。通过倾向得分匹配,我们选择了34367名使用RYR的患者和34367名使用洛伐他汀的患者。我们确定了两个队列在 2010 年至 2019 年随访期间发生的肝硬化事件。我们在多重 Cox 比例危险模型中计算了与使用 RYR 相关的肝硬化风险的调整后危险比(HRs)和 95% 置信区间(Cis):与使用洛伐他汀的患者相比,使用 RYR 的患者罹患肝硬化的风险较低(HR 0.60,95% CI 0.57-0.63),而且这种关联在不同的亚组中都很显著。使用 RYR 的频率与肝硬化发生率的降低之间存在生物梯度关系(趋势 p 为 0.0001)。肝硬化后黄疸(HR 0.56,95% CI 0.43-0.72)、腹水(HR 0.37,95% CI 0.28-0.50)、肝昏迷(HR 0.36,95% CI 0.26-0.50)和死亡率(HR 0.48,95% CI 0.38-0.61)的降低也与使用 RYR 有关:结论:我们的研究表明,使用 RYR 对肝硬化的风险和预后都有益处,但应考虑到缺乏依从性数据。然而,我们的研究并未推断出因果关系,也未宣称红酵母米优于洛伐他汀。关键词:高脂血症 肝硬化 洛伐他汀 结局 红酵母米 风险
Real-World Risk and Outcome of Liver Cirrhosis in Patients with Hyperlipidemia Treated with Red Yeast Rice: A Retrospective Cohort Study
Objective: Sustained hyperlipidemia contributes to fatty liver and liver cirrhosis. Red yeast rice (RYR) effectively improved the lipid profile; however, the effects of RYR on the risk of incident liver cirrhosis remain to be elucidated. We aimed to evaluate the beneficial effects of RYR use on the risk and outcome of liver cirrhosis. Patients and methods: We identified 156,587 adults who had newly diagnosed hyperlipidemia in 2010– 2016 from health insurance data in this retrospective cohort study. Using propensity score matching, we selected 34,367 patients who used RYR and 34,367 patients who used lovastatin. Events of incident liver cirrhosis that occurred in the two cohorts during the follow-up period of 2010– 2019 were identified. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (Cis) for liver cirrhosis risk associated with RYR use in the multiple Cox proportional hazard model. Results: Compared with patients who used lovastatin, patients who used RYR had a decreased risk of liver cirrhosis (HR 0.60, 95% CI 0.57– 0.63), and this association was significant in various subgroups. A biological gradient relationship between the frequency of RYR use and decreased liver cirrhosis was observed (p for trend < 0.0001). Reduced postcirrhosis jaundice (HR 0.56, 95% CI 0.43– 0.72), ascites (HR 0.37, 95% CI 0.28– 0.50), hepatic coma (HR 0.36, 95% CI 0.26– 0.50), and mortality (HR 0.48, 95% CI 0.38– 0.61) were also associated with RYR use. Conclusion: We demonstrated the beneficial effects of RYR use on the risk and outcome of liver cirrhosis; however, the lack of compliance data should be considered. However, our study did not infer causality or claim the superiority of RYR over lovastatin.
Keywords: hyperlipidemia, liver cirrhosis, lovastatin, outcome, red yeast rice, risk
期刊介绍:
The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.