It is possible that appetite-regulating hormones modulate both humoral immunity and liver function. Further studies with a larger number of subjects are needed to clarify the precise mechanisms of this association.

BackgroundMultiple comorbidity is common and increases the complexity of the presentation of patients with COPD. This study was a comprehensive analysis of the relationship between a medical history of 22 disease categories and the presence of airflow limitation (AL) without any history of asthma or bronchiectasis, compatible with COPD.MethodsA total of 11,898 Japanese patients aged ≥40 years, who underwent spirometry tests, comprising patients with AL (n=2,309) or without AL (n=9,589), were evaluated. Generalized estimating equations were used to assess the relationship between the presence of AL and each disease. The model was adjusted for age, sex, body mass index (BMI) and pack-years of smoking.ResultsIn multivariate analysis, female sex (odds ratio [OR]: 0.59; 95% confidence interval [CI]: 0.52–0.67), age (OR for 10-year age increase: 1.99; CI: 1.90–2.09), BMI (OR for 1 kg/m2 increase: 0.96; CI: 0.95–0.98) and smoking history (<15 vs 15–24, 25–49 and ≥50 pack-years; OR: 1.78, 2.6 and 3.69, respectively; CI: 1.46–2.17, 2.24–3.0 and 3.15–4.33, respectively) were significantly associated with the presence of AL. In addition, a history of tuberculosis (OR: 1.72; CI: 1.39–2.11), primary lung cancer (OR: 1.50; CI: 1.28–1.77), myocardial infarction (OR: 1.22; CI: 1.01–1.48), heart failure (OR: 1.53; CI: 1.29–1.81), arrhythmia (OR: 1.19; CI: 1.03–1.38) or heart valve disorder (OR: 1.33; CI: 1.14–1.56) was significantly associated with the presence of AL, after adjustment.ConclusionThis study suggests that a history of heart disease leading to abnormal cardiac function may be associated with AL and that the presence of certain types of heart disease provides a rationale to assess lung status and look for respiratory impairment, including COPD.

A change in risk of an event occurring, which is affected with a factor, is a common issue in many research fields, and relative risk is widely used because of intuitive interpretation. Estimating relative risk has required data from two follow-up groups and can thus be cost and time consuming. Subjects for whom an event occurred (case group) are often observed but generally analyzed in comparison to those for whom an event did not (control group); however, estimating relative risk using case group data without approximation is hindered. In this study, an obstacle to estimate relative risk using case control data is clarified as a mathematical expression and a new equation to estimate relative risk using the exposed proportion and case group data is proposed. The proposed equation is derived without using the Bayesian methods. A method to estimate the confidence interval for the proposed estimator is also provided. The usefulness of the proposed equation, which requires neither control nor follow-up groups, is demonstrated for both theoretical and real-life examples.

We conducted a retrospective cohort study to evaluate and compare the long-term effects of two single-pill fixed-dose combinations (FDCs), candesartan/amlodipine and olmesartan/azelnidipine, on laboratory parameters in patients in routine clinical practice. We identified an equal number of new users (n = 182) of a candesartan/amlodipine (8/5 mg/day) FDC tablet (CAN/AML users) and a propensity-score matched cohort (n = 182) receiving an olmesartan/azelnidipine (20/16 mg/day) FDC tablet (OLM/AZ users). Generalized estimating equations were used to estimate and compare the effects of the drugs on serum levels of creatinine, estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), uric acid, sodium, potassium, aspartate aminotransferase, and alanine aminotransferase levels up to 12 months after the start of study drug administration. There was a significant increase of serum creatinine level and a significant decrease of eGFR from the baseline period to during the exposure period in both CAN/AML and OLM/AZ users, and a significant increase of BUN level in CAN/AML users. However, there were no significant differences in the mean changes of laboratory parameters between CAN/AML and OLM/AZ users. Our findings suggested that the effects of CAN/AML and OLM/AZ on laboratory parameters, including an unfavorable effect on renal function, were similar at least during 1 year of administration.

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