• Pei-Hsien Chen, Chiu-Lin Tsai, Yow-Wen Hsieh, Der-Yang Cho, Fuu-Jen Tsai, Cheng-Li Lin, and Hsien-Yin Liao.
• Department of Chinese Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC.
• J Chin Med Assoc. 2024 Oct 1; 87 (10): 961968961-968.

BackgroundSeveral risk factors for peptic ulcer disease (PUD) have been identified; however, the recurrence rate of PUD remains high even with standard ulcer treatments. High cholesterol levels have been proposed as a risk factor for PUD, but clinical evidence remains limited. Therefore, this database study investigated whether hyperlipidemia increases PUD risk and whether antihyperlipidemic drugs reduce this risk.MethodsA long-term cohort design was adopted, and Taiwan's National Health Insurance Research Database was used to enroll patients diagnosed with hyperlipidemia between 2000 and 2016. Patients without hyperlipidemia were randomly matched based on variables such as age and gender to establish a comparison cohort at a 1:1 ratio. Another cohort study was conducted to determine whether antihyperlipidemic drugs or red yeast rice prescriptions can reduce the incidence of PUD in patients with hyperlipidemia.ResultsThe overall incidence of PUD was 1.48 times higher in the hyperlipidemia cohort (203,235 patients) than in the nonhyperlipidemia cohort (adjusted hazard ratio, 1.48; 95% CI, 1.46-1.50; p < 0.001). Among the patients with hyperlipidemia, those who used antihyperlipidemic drugs with or without red yeast rice prescriptions exhibited a lower risk of developing PUD relative to those who did not use them; the adjusted hazard ratios were 0.33 (95% CI, 0.21-0.52) and 0.81 (95% CI, 0.78-0.84), respectively. When the cumulative exposure to antihyperlipidemic drugs and red yeast rice prescriptions increased, the risk of developing PUD showed a decreasing trend, which was statistically significant for antihyperlipidemic drugs but not for red yeast rice.ConclusionHyperlipidemia is associated with a higher risk of PUD, which can be reduced through the administration of antihyperlipidemic drugs with or without red yeast rice prescriptions.Copyright © 2024, the Chinese Medical Association.

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