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Published in: Acta Diabetologica 7/2017

01-07-2017 | Original Article

Effect of statins on hospitalization risk of bacterial infections in patients with or without diabetes

Authors: Laura Policardo, Giuseppe Seghieri, Roberto Anichini, Paolo Francesconi

Published in: Acta Diabetologica | Issue 7/2017

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Abstract

Aims

To investigate whether statins reduce the risk to first hospitalization of bacterial infections, in patients with or without diabetes taking into account prior or incident comorbidities.

Methods

By using administrative databases, the effect of current statin use was measured on the risk of first hospitalizations due to bacterial infections in people living in Tuscany, Italy, in the period January 1, 2011–December 31, 2015, after excluding those with previous statins use. Population was stratified as with (n = 128,207) or without diabetes (n = 3,304,906), and the hospitalization risk was analyzed by a Cox proportional hazards regression analysis after adjusting for age, gender, previous comorbidities, chronic renal failure, and prior or incident cardiovascular diseases.

Results

During the 5-year follow-up, 31,543 hospitalizations for bacterial infections were observed: 2.08(2.06–2.10) per 1000 person-year in non-diabetic and 5679: 9.13(8.94–9.32) per 1000 person-year in diabetic population. Diabetes conferred a greater risk of hospitalizations, independently from confounders [adjusted HR (95% CI) 2.04 (1.97–2.10); P < 0.0001]. Statin use decreased the risk by about 2.5% for each one month of therapy, at the same extent in subjects with or without diabetes, after adjusting for all covariates.

Conclusions

In this population, diabetes was associated by a twofold increase in the 5-year risk of hospitalizations for bacterial infections. Statin use decreased this risk to a same extent in subjects without or with diabetes, after adjusting for main confounders including comorbidities, and previous or incident cardiovascular events.
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Literature
1.
go back to reference Tleyjeh IM, Kashour T, Hakim FA, Zimmerman VA, Erwin PJ, Sutton AJ et al (2009) Statins for the prevention and treatment of infections: a systematic review and meta-analysis. Arch Intern Med 169:1658–1667CrossRefPubMed Tleyjeh IM, Kashour T, Hakim FA, Zimmerman VA, Erwin PJ, Sutton AJ et al (2009) Statins for the prevention and treatment of infections: a systematic review and meta-analysis. Arch Intern Med 169:1658–1667CrossRefPubMed
2.
go back to reference Chua D, Tsang RS, Kuo IF (2007) The role of statin therapy in sepsis. Ann Pharmacother 41:647–652CrossRefPubMed Chua D, Tsang RS, Kuo IF (2007) The role of statin therapy in sepsis. Ann Pharmacother 41:647–652CrossRefPubMed
3.
go back to reference Falagas ME, Makris GC, Matthaiou DK, Rafailidis PI (2008) Statins for infection and sepsis: a systematic review of the clinical evidence. J Antimicrob Chemother 61:774–785CrossRefPubMed Falagas ME, Makris GC, Matthaiou DK, Rafailidis PI (2008) Statins for infection and sepsis: a systematic review of the clinical evidence. J Antimicrob Chemother 61:774–785CrossRefPubMed
4.
go back to reference Viasus D, Garcia-Vidal C, Gudiol F, Carratalà J (2010) Statins for community-acquired pneumonia: current state of the science. Eur J Clin Microbiol Infect Dis 29:143–152CrossRefPubMed Viasus D, Garcia-Vidal C, Gudiol F, Carratalà J (2010) Statins for community-acquired pneumonia: current state of the science. Eur J Clin Microbiol Infect Dis 29:143–152CrossRefPubMed
5.
go back to reference Chalmers JD, Singanayagam A, Murray MP, Hill AT (2008) Prior statin use is associated with improved outcomes in community-acquired pneumonia. Am J Med 121:1002–1007CrossRefPubMed Chalmers JD, Singanayagam A, Murray MP, Hill AT (2008) Prior statin use is associated with improved outcomes in community-acquired pneumonia. Am J Med 121:1002–1007CrossRefPubMed
6.
go back to reference Mortensen EM, Copeland LA, Pugh MJ, Pugh MJ, Restrepo MI, de Molina RM et al (2009) Impact of statins and ACE inhibitors on mortality after COPD exacerbations. Respir Res 10:45CrossRefPubMedPubMedCentral Mortensen EM, Copeland LA, Pugh MJ, Pugh MJ, Restrepo MI, de Molina RM et al (2009) Impact of statins and ACE inhibitors on mortality after COPD exacerbations. Respir Res 10:45CrossRefPubMedPubMedCentral
7.
go back to reference Dobesh PP, Olsen KM (2014) Statins role in the prevention and treatment of sepsis. Pharmacol Res 88:31–40CrossRefPubMed Dobesh PP, Olsen KM (2014) Statins role in the prevention and treatment of sepsis. Pharmacol Res 88:31–40CrossRefPubMed
8.
go back to reference Almog Y, Shefer A, Novack V, Maimon N, Barski L, Eizinger M et al (2004) Prior statin therapy is associated with a decreased rate of severe sepsis. Circulation 17(110):880–885CrossRef Almog Y, Shefer A, Novack V, Maimon N, Barski L, Eizinger M et al (2004) Prior statin therapy is associated with a decreased rate of severe sepsis. Circulation 17(110):880–885CrossRef
10.
go back to reference van den Hoek HL, Bos WJ, de Boer A, van de Garde EM (2011) Statins and prevention of infections: systematic review and meta-analysis of data from large randomized placebo controlled trials. BMJ 29(343):d7281CrossRef van den Hoek HL, Bos WJ, de Boer A, van de Garde EM (2011) Statins and prevention of infections: systematic review and meta-analysis of data from large randomized placebo controlled trials. BMJ 29(343):d7281CrossRef
12.
go back to reference Hamilton EJ, Martin N, Makepeace A, Sillars BA, Davis WA, Davis TM (2013) Incidence and predictors of hospitalization for bacterial infection in community-based patients with type 2 diabetes: the Fremantle diabetes study. PLoS ONE 8:e60502CrossRefPubMedPubMedCentral Hamilton EJ, Martin N, Makepeace A, Sillars BA, Davis WA, Davis TM (2013) Incidence and predictors of hospitalization for bacterial infection in community-based patients with type 2 diabetes: the Fremantle diabetes study. PLoS ONE 8:e60502CrossRefPubMedPubMedCentral
13.
go back to reference van de Garde EM, Hak E, Souverein PC, Hoes AW, van den Bosch JM, Leufkens HG (2006) Statin treatment and reduced risk of pneumonia in patients with diabetes. Thorax 61:957–961CrossRefPubMedPubMedCentral van de Garde EM, Hak E, Souverein PC, Hoes AW, van den Bosch JM, Leufkens HG (2006) Statin treatment and reduced risk of pneumonia in patients with diabetes. Thorax 61:957–961CrossRefPubMedPubMedCentral
14.
go back to reference Joshi N, Caputo GM, Weitekamp MR, Karchmer AW (1999) Infections in patients with diabetes mellitus. N Engl J Med 341:1906–1912CrossRefPubMed Joshi N, Caputo GM, Weitekamp MR, Karchmer AW (1999) Infections in patients with diabetes mellitus. N Engl J Med 341:1906–1912CrossRefPubMed
16.
17.
go back to reference Hux JE, Ivis F, Flintoft V, Bica A (2002) Diabetes in Ontario: determination of prevalence and incidence using a validated administrative data algorithm. Diabetes Care 25:512–517CrossRefPubMed Hux JE, Ivis F, Flintoft V, Bica A (2002) Diabetes in Ontario: determination of prevalence and incidence using a validated administrative data algorithm. Diabetes Care 25:512–517CrossRefPubMed
18.
go back to reference Bertoni AG, Saydah S, Brancati FL (2001) Diabetes and the risk of infection-related mortality in the U.S. Diabetes Care 24:1044–1049CrossRefPubMed Bertoni AG, Saydah S, Brancati FL (2001) Diabetes and the risk of infection-related mortality in the U.S. Diabetes Care 24:1044–1049CrossRefPubMed
19.
go back to reference Thomsen RW, Hundborg HH, Lervang HH, Johnsen SP, Schønheyder HC, Sørensen HT (2004) Risk of community-acquired pneumococcal bacteremia in patients with diabetes: a population-based case-control study. Diabetes Care 27:1143–1147CrossRefPubMed Thomsen RW, Hundborg HH, Lervang HH, Johnsen SP, Schønheyder HC, Sørensen HT (2004) Risk of community-acquired pneumococcal bacteremia in patients with diabetes: a population-based case-control study. Diabetes Care 27:1143–1147CrossRefPubMed
20.
go back to reference Shah BR, Hux JE (2003) Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care 26:510–513CrossRefPubMed Shah BR, Hux JE (2003) Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care 26:510–513CrossRefPubMed
21.
go back to reference Hackam DG, Mamdani M, Li P (2006) Statins and sepsis in patients with cardiovascular disease: a population-based cohort analysis. Lancet 367:413–418CrossRefPubMed Hackam DG, Mamdani M, Li P (2006) Statins and sepsis in patients with cardiovascular disease: a population-based cohort analysis. Lancet 367:413–418CrossRefPubMed
22.
go back to reference Thomsen RW, Hundborg HH, Johnsen SP, Pedersen L, Sørensen HT, Schønheyder HC et al (2006) Statin use and mortality within 180 days after bacteremia: a population-based cohort study. Crit Care Med 34:1080–1086CrossRefPubMed Thomsen RW, Hundborg HH, Johnsen SP, Pedersen L, Sørensen HT, Schønheyder HC et al (2006) Statin use and mortality within 180 days after bacteremia: a population-based cohort study. Crit Care Med 34:1080–1086CrossRefPubMed
23.
go back to reference Gini R, Francesconi P, Mazzaglia G, Cricelli I, Pasqua A, Gallina P et al (2013) Chronic disease prevalence from Italian administrative databases in the VALORE project: a validation through comparison of population estimates with general practice databases and national survey. BMC Public Health 13:15CrossRefPubMedPubMedCentral Gini R, Francesconi P, Mazzaglia G, Cricelli I, Pasqua A, Gallina P et al (2013) Chronic disease prevalence from Italian administrative databases in the VALORE project: a validation through comparison of population estimates with general practice databases and national survey. BMC Public Health 13:15CrossRefPubMedPubMedCentral
24.
go back to reference Andrade SE, Kahler KH, Frech F, Chan KA (2006) Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf 15:565–574CrossRefPubMed Andrade SE, Kahler KH, Frech F, Chan KA (2006) Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf 15:565–574CrossRefPubMed
25.
go back to reference Blanco-Colio LM, Tunon J, Martin-Ventura JL, Egido J (2003) Antiinflammatory and immunomodulatory effects of statins. Kidney Int 63:12–23CrossRefPubMed Blanco-Colio LM, Tunon J, Martin-Ventura JL, Egido J (2003) Antiinflammatory and immunomodulatory effects of statins. Kidney Int 63:12–23CrossRefPubMed
26.
go back to reference Kwak B, Mulhaupt F, Myit S, Mach F (2000) Statins as a newly recognized type of immunomodulator. Nat Med 6:1399–1402CrossRefPubMed Kwak B, Mulhaupt F, Myit S, Mach F (2000) Statins as a newly recognized type of immunomodulator. Nat Med 6:1399–1402CrossRefPubMed
28.
go back to reference Werner N, Nickenig G, Laufs U (2002) Pleiotropic effects of HMG-CoA reductase inhibitors. Basic Res Cardiol 97:105–116CrossRefPubMed Werner N, Nickenig G, Laufs U (2002) Pleiotropic effects of HMG-CoA reductase inhibitors. Basic Res Cardiol 97:105–116CrossRefPubMed
29.
go back to reference Youssef S, Stuve O, Patarroyo JC, Ruiz PJ, Radosevich JL, Hur EM et al (2002) The HMG-CoA reductase inhibitor, atorvastatin, promotes a Th2 bias and reverses paralysis in central nervous system autoimmune disease. Nature 420:78–84CrossRefPubMed Youssef S, Stuve O, Patarroyo JC, Ruiz PJ, Radosevich JL, Hur EM et al (2002) The HMG-CoA reductase inhibitor, atorvastatin, promotes a Th2 bias and reverses paralysis in central nervous system autoimmune disease. Nature 420:78–84CrossRefPubMed
31.
go back to reference Terblanche M, Almog Y, Rosenson RS, Smith TS, Hackam DG (2006) Statins: panacea for sepsis? Lancet Infect Dis 6:242–248CrossRefPubMed Terblanche M, Almog Y, Rosenson RS, Smith TS, Hackam DG (2006) Statins: panacea for sepsis? Lancet Infect Dis 6:242–248CrossRefPubMed
32.
go back to reference Collins R, Reith C, Emberson J, Armitage J, Baigent C, Blackwell L et al (2016) Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet 388:2532–2561CrossRefPubMed Collins R, Reith C, Emberson J, Armitage J, Baigent C, Blackwell L et al (2016) Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet 388:2532–2561CrossRefPubMed
33.
Metadata
Title
Effect of statins on hospitalization risk of bacterial infections in patients with or without diabetes
Authors
Laura Policardo
Giuseppe Seghieri
Roberto Anichini
Paolo Francesconi
Publication date
01-07-2017
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 7/2017
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-017-0990-1

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