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Hydrophilic and lipophilic statin use and risk of hearing loss in hyperlipidemia using a Common Data Model:
Insik Song1, Minjin Kim2,3, Hangseok Choi2,3
1Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
Insights
Hydrophilic statins may reduce hearing loss risk compared to lipophilic statins in hyperlipidemia patients. This finding suggests a potential preventive role for hydrophilic statins in managing hearing impairment.
Area of Science:
- Cardiology and Otolaryngology
- Pharmacology and Pharmacoepidemiology
Background:
- Hearing impairment is a significant global health issue with limited treatment options.
- Hyperlipidemia is a common condition often managed with statin therapy.
Purpose of the Study:
- To compare the risk of hearing loss in patients with hyperlipidemia treated with hydrophilic versus lipophilic statins.
- To investigate the differential effects of statin types on hearing impairment incidence.
Main Methods:
- Retrospective multicenter study using a Common Data Model database from three South Korean hospitals.
- Propensity score matching, Cox proportional regression, and meta-analysis were employed to compare hearing loss risk.
- Data included 37,322 hyperlipidemia patients, analyzing hearing loss occurrence post-diagnosis.
Main Results:
- Overall meta-analysis showed a statistically significant lower risk of hearing loss in hydrophilic statin users compared to lipophilic statin users (HR, 0.40; 95% CI, 0.18-0.91).
- No significant difference in hearing loss risk was observed among hospitals after propensity score matching.
- Male patients in the hydrophilic statin group exhibited a reduced risk of hearing impairment.
Conclusions:
- Hydrophilic statins may be associated with a lower risk of hearing loss in hyperlipidemia patients compared to lipophilic statins.
- Further research is warranted to confirm these findings and explore the underlying mechanisms.
- Statin selection might play a role in mitigating hearing impairment risk in specific patient populations.
Abstract:
Hearing impairment, the third largest health burden worldwide, currently lacks definitive treatments or preventive drugs. This study compared the effects of hydrophilic and lipophilic statin on hearing loss using a common database model. This retrospective multicenter study was conducted in three hospitals in South Korea (Anam, Guro, Ansan). We enrolled patients with hyperlipidemia with an initial hearing loss diagnosis. Data were collected during January 1, 2022-December 31, 2021 using the Observational Health Data Science and Informatics open-source software and Common Data Model database. The primary outcome was the occurrence of first-time hearing loss following a hyperlipidemia diagnosis, as documented in the Common Data Model cohort database. The measures of interest were hearing loss risk between hydrophilic and lipophilic statin use. Variables were compared using propensity score matching, Cox proportional regression, and meta-analysis. Among 37,322 patients with hyperlipidemia, 13,751 (7669 men and 6082 women) and 23,631 (11,390 men and 12,241 women) were treated with hydrophilic and lipophilic statins, respectively. After propensity score matching, according to the Kaplan-Meier curve, hearing loss risk did not significantly differ among the hospitals. The hazard ratio (HR) of the male patients from Anam (0.29, [95% confidence interval (CI), 0.05-1.51]), Guro (HR, 0.56, [95% CI 0.18-1.71]), and Ansan (hazard ratio, 0.29, [95% CI 0.05-1.51]) hospitals were analyzed using Cox proportional regression. Overall effect size (HR, 0.40, [95% CI 0.18-0.91]) was estimated using meta-analysis, which indicated that hearing loss risk among hydrophilic statin users was less than that among lipophilic statin users and was statistically significant. Men in the hydrophilic statin group had a lower risk of hearing impairment than those in the lipophilic statin group.
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