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Increased risk of chronic obstructive pulmonary disease in patients with systemic lupus erythematosus: a population-based cohort study.
PLoS One 2014; 9(3):e91821Plos

Abstract

BACKGROUND

There is increasing evidence that autoimmune disease is associated with development of chronic obstructive pulmonary disease (COPD). We aim to assess the relationship between systemic lupus erythematosus (SLE) and COPD risk in a nationwide population.

METHODS

We conducted a retrospective cohort study using the catastrophic illness registry of the Taiwan National Health Insurance Research Database (NHIRD). We identified 10,623 patients with SLE newly diagnosed between 2000 and 2010. Each patient was randomly frequency-matched with four people without SLE on age, sex, and index year from the general population. Both cohorts were followed up until the end of 2010 to measure the incidence of COPD. The risk of COPD was analyzed using Cox proportional hazards regression models including age, sex, index year and comorbidities.

RESULTS

The overall incidence rate of COPD was 1.73-fold higher in the SLE cohort than in the control cohort (17.4 vs. 10.1 per 10,000 person-years, 95% CI = 1.62-1.84). Age related analysis showed increased incidence of COPD with age in both SLE and control cohorts. However, adjusted HR maximum was observed in the youngest age group (adjusted HR: 4.33, 95% CI, 2.39-7.85) while adjusted HR minimum was witnessed in the oldest age group (adjusted HR: 1.19, 95% CI, 0.85-1.22).

CONCLUSION

Patients with SLE have a significant risk of developing COPD than the control population. Based on the findings from this study, it can be hypothesized that in addition to cigarette smoke SLE may be a determining factor for COPD incidence. However, further investigation is needed to corroborate this hypothesis.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chu Shang Show Chwan Hospital, Nantou, Taiwan.Department of Public Health, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan.Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24622340

Citation

Shen, Te-Chun, et al. "Increased Risk of Chronic Obstructive Pulmonary Disease in Patients With Systemic Lupus Erythematosus: a Population-based Cohort Study." PloS One, vol. 9, no. 3, 2014, pp. e91821.
Shen TC, Lin CL, Chen CH, et al. Increased risk of chronic obstructive pulmonary disease in patients with systemic lupus erythematosus: a population-based cohort study. PLoS ONE. 2014;9(3):e91821.
Shen, T. C., Lin, C. L., Chen, C. H., Tu, C. Y., Hsia, T. C., Shih, C. M., ... Chang, Y. J. (2014). Increased risk of chronic obstructive pulmonary disease in patients with systemic lupus erythematosus: a population-based cohort study. PloS One, 9(3), pp. e91821. doi:10.1371/journal.pone.0091821.
Shen TC, et al. Increased Risk of Chronic Obstructive Pulmonary Disease in Patients With Systemic Lupus Erythematosus: a Population-based Cohort Study. PLoS ONE. 2014;9(3):e91821. PubMed PMID: 24622340.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased risk of chronic obstructive pulmonary disease in patients with systemic lupus erythematosus: a population-based cohort study. AU - Shen,Te-Chun, AU - Lin,Cheng-Li, AU - Chen,Chia-Hung, AU - Tu,Chih-Yen, AU - Hsia,Te-Chun, AU - Shih,Chuen-Ming, AU - Hsu,Wu-Huei, AU - Chang,Yen-Jung, Y1 - 2014/03/12/ PY - 2013/12/23/received PY - 2014/02/15/accepted PY - 2014/3/14/entrez PY - 2014/3/14/pubmed PY - 2015/5/30/medline SP - e91821 EP - e91821 JF - PloS one JO - PLoS ONE VL - 9 IS - 3 N2 - BACKGROUND: There is increasing evidence that autoimmune disease is associated with development of chronic obstructive pulmonary disease (COPD). We aim to assess the relationship between systemic lupus erythematosus (SLE) and COPD risk in a nationwide population. METHODS: We conducted a retrospective cohort study using the catastrophic illness registry of the Taiwan National Health Insurance Research Database (NHIRD). We identified 10,623 patients with SLE newly diagnosed between 2000 and 2010. Each patient was randomly frequency-matched with four people without SLE on age, sex, and index year from the general population. Both cohorts were followed up until the end of 2010 to measure the incidence of COPD. The risk of COPD was analyzed using Cox proportional hazards regression models including age, sex, index year and comorbidities. RESULTS: The overall incidence rate of COPD was 1.73-fold higher in the SLE cohort than in the control cohort (17.4 vs. 10.1 per 10,000 person-years, 95% CI = 1.62-1.84). Age related analysis showed increased incidence of COPD with age in both SLE and control cohorts. However, adjusted HR maximum was observed in the youngest age group (adjusted HR: 4.33, 95% CI, 2.39-7.85) while adjusted HR minimum was witnessed in the oldest age group (adjusted HR: 1.19, 95% CI, 0.85-1.22). CONCLUSION: Patients with SLE have a significant risk of developing COPD than the control population. Based on the findings from this study, it can be hypothesized that in addition to cigarette smoke SLE may be a determining factor for COPD incidence. However, further investigation is needed to corroborate this hypothesis. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24622340/Increased_risk_of_chronic_obstructive_pulmonary_disease_in_patients_with_systemic_lupus_erythematosus:_a_population_based_cohort_study_ L2 - http://dx.plos.org/10.1371/journal.pone.0091821 DB - PRIME DP - Unbound Medicine ER -