McGwin G, Owsley C, Curcio C A, Crain R J
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL , USA.
Br J Ophthalmol. 2003 Sep;87(9):1121-5. doi: 10.1136/bjo.87.9.1121.
To evaluate the association between age related maculopathy (ARM) and statin use.
A nested case-control study among patients at the Veterans Affairs Medical Center in Birmingham, Alabama, with newly diagnosed ARM (cases) between 1997 to 2001 were selected and age matched to non-ARM controls.
550 incident cases of ARM were identified and matched to 5500 controls. Overall, cases were 70% (OR 0.30, 95% CI 0.21 to 0.45) less likely to have received and filled a statin prescription relative to the controls. This association was present among both current and past (OR 0.34, 95% CI 0.21 to 0.53 and OR 0.26, 95% CI 0.14 to 0.47, respectively) statin users. When considering use of statin and/or non-statin lipid lowering medications, a significant risk reduction was observed for statin only users (OR 0.30, 95% CI 0.20 to 0.45) and combined statin and non-statin users (OR 0.20, 95% CI 0.06 to 0.64); there was no significant association for non-statin only users (OR 0.47, 95% CI 0.20 to 1.13).
The results of this study suggest that subjects with ARM were significantly less likely to have filled a statin prescription. Future clinical research initiatives should include a clinical trial to provide direct evidence of the effectiveness of statins in lowering the incidence and progression of ARM.
评估年龄相关性黄斑病变(ARM)与他汀类药物使用之间的关联。
在阿拉巴马州伯明翰退伍军人事务医疗中心的患者中进行一项巢式病例对照研究,选取1997年至2001年间新诊断为ARM的患者(病例组),并与非ARM对照组进行年龄匹配。
共识别出550例ARM发病病例,并与5500例对照进行匹配。总体而言,与对照组相比,病例组患者接受并使用他汀类药物处方的可能性低70%(比值比0.30,95%置信区间0.21至0.45)。这种关联在当前和既往他汀类药物使用者中均存在(当前使用者比值比0.34,95%置信区间0.21至0.53;既往使用者比值比0.26,95%置信区间0.14至0.47)。在考虑使用他汀类药物和/或非他汀类降脂药物时,仅使用他汀类药物的使用者(比值比0.30,95%置信区间0.20至0.45)和同时使用他汀类药物和非他汀类药物的使用者(比值比0.20,95%置信区间0.06至0.64)的风险显著降低;仅使用非他汀类药物的使用者无显著关联(比值比0.47,95%置信区间0.20至1.13)。
本研究结果表明,患有ARM的受试者开具他汀类药物处方的可能性显著降低。未来的临床研究应包括一项临床试验,以提供他汀类药物降低ARM发病率和进展有效性的直接证据。