International Journal of Epidemiology, Vol 26, 1191-1202, Copyright © 1997 by International Epidemiological Association
C Iribarren, DR Jacobs Jr, S Sidney, AJ Claxton, MD Gross, M Sadler and H Blackburn
BACKGROUND: In earlier studies, serum total cholesterol was inversely
associated with death due to respiratory diseases. METHODS: Relationships
of cholesterol with risk of respiratory diseases were examined between 1978
and 1993 in a health maintenance organization in Northern California
(48,188 men, 55,276 women, about 60% white, age range 25-89). Incident and
fatal endpoints were ascertained using hospital discharge diagnostic codes
and underlying cause of death, respectively. RESULTS: An inverse
association of cholesterol level with pneumonia/influenza hospitalization
was found among men and women except that, contrary to hypothesis, a
positive association was seen in women under 55 years of age. Inconsistent
inverse associations were found in men, but not women, between cholesterol
level and hospitalization for chronic obstructive pulmonary disease (COPD).
Hospitalization for asthma was unrelated to cholesterol level. An inverse
association existed between cholesterol level and hospitalization for
miscellaneous respiratory diseases among men, but not women. Exclusion of
early hospitalizations tended to attenuate risk for cholesterol level below
4.14 mmol/l, but not the risk gradient across higher cholesterol levels.
For deaths, cholesterol level was statistically significantly inversely
associated only with COPD. CONCLUSIONS: Cholesterol had graded inverse
associations with some respiratory diseases, but not others, tending to be
stronger in men than in women, and in older than in younger participants.
Associations varied for hospitalizations compared to deaths. More
epidemiological and basic research is needed to elucidate the potential
mechanisms underlying the observed associations.
ARTICLES
Serum total cholesterol and risk of hospitalization, and death from respiratory disease
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94611, USA.
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