After the observation, CLs were replaced with re-suturing of tarsorrhaphy

rt our findings of an association between statin use and HZ occurrence. Interestingly, we found that younger PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19719889 statin users were at higher risk of suffering from HZ than their older counterparts in the present study. We hypothesized that this phenomenon may be partially explained by the characteristics of HZ occurrence. The prevalence of HZ increases in the elderly. Therefore, the effects of statin on HZ may be diluted in the elderly. We found the even PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19717433 irregular statin users were associated with an increased risk of HZ occurrence, although the risk for HZ occurrence in irregular statin users was lower than that of regular statin users. We proposed two hypothesis regarding these findings. First, the association between statin and HZ occurrence could be dose-dependent. A higher dose of statin may be associated with a higher risk of HZ occurrence. However, in the study by Antoniou et al., no difference of risk for HZ was demonstrated among the users with difference doses of statin. The authors proposed this finding may be associated with limited power from only few people had increased their dose form baseline dose in study population. Second, the vulnerability of subjects using statins to HZ may be quite high. In such cases, subjects with little exposure under irregular statin use were still at a significantly higher risk of HZ occurrence compared to non-statin users. There are some insufficiencies in present study. First, potential mis-coding and non-coding of health registry-based studies may hamper the results of the present study. Nevertheless, the Taiwan NHI Bureau has a cross-checking mechanism to facilitate the accuracy of the coding in this system. In general, it is believed that the LHID2000 has good quality for epidemiological analyses. Second, we pooled all types of statin in the analysis. Because the potency for immune-modulation may vary among different types of statin, specific types of statin may carry higher risks for HZ. Third, some variables regarding blood levels of lipid profile were lacking in the present study. Therefore, the status of dyslipidemia after being controlled by statin could not be determined. Potential confounding by underlying dyslipidemia of HZ occurrence still cannot be excluded in the present study. Fourth, some basic profiles of body weight, physical activity, nutritional status, and alcohol consumption which could act as potential confounding factors were not shown in the study. Fifth, although we adjusted for comorbidities and basic demographic data of subjects in the analysis, medication profiles were not adjusted to avoid excessively Use of statin 18,44 Subjects with herpes zoster n, % Yes Crude OR Adjusted OR 410 1.74 1.69 AZD-6244 biological activity Controls n, % 705 1.00 1.00 Age group 45,64 Subjects with herpes zoster n, % 3679 1.49 1.44 Controls n, % 7899 1.00 1.00.64 Subjects with herpes Controls zoster n, % n, % 3226 1.15 1.14 8604 1.00 1.00 Notes: The OR was calculated by a conditional logistic regression which was conditioned on gender and index year. p,0.001. Adjustments are made for subject’s Charlson Comorbidity Index score. doi:10.1371/journal.pone.0111268.t002 3 Herpes Zoster and Statin Use Use of statin Male Subjects with herpes zoster n, % Yes Crude OR Adjusted OR 3051 1.28 1.23 Controls n, % 7380 1.00 1.00 Gender Female Subjects with herpes zoster n, % 4264 1.36 1.32 Controls n, % 9828 1.00 1.00 Notes: The OR was calculated by a conditional logistic regression which was conditioned on age group and index yea