Department of Ophthalmology, Southern California Permanente Medical Group, Baldwin Park, CA 91101, USA.
Am J Ophthalmol. 2012 Feb;153(2):222-228.e1. doi: 10.1016/j.ajo.2011.08.001. Epub 2011 Oct 6.
To investigate whether the statin class of drugs reduces the risk of cataract extraction.
Case-control study.
setting: Kaiser Permanente Southern California, which provides prepaid healthcare for 3.2 million residents by 6000 physicians. patient population: Eligible patients were those who had 5+ years of continuous enrollment in 2009. Cases were 13 982 patients who underwent cataract surgery in their first eye in 2009. Controls were the 34 049 patients who had an eye examination, but did not undergo cataract surgery or have a diagnosis of cataract in their medical record. observation procedure: The primary source of data to assess cataract surgery, treatment with statins, and other risk factors is the electronic database of Kaiser Permanente. main outcome measure: Use of the statin class of drug.
Patients who had cataract surgery were older, were more likely to be white, and appeared to have more coronary artery disease but less diabetes. The proportion of statin users appeared to be greater among those with cataract surgery (64.3%) compared to those without a diagnosis of cataract or cataract surgery (55.5%). After adjustment for age, sex, race, smoking status, diabetes, and coronary artery disease, longer-term statin use was found to be protective against cataract extraction (OR: 0.93, P = .02), while shorter-term use was associated with cataract surgery (OR: 1.11, P < .0001). Age-stratified logistic regression analysis showed that statin use of 5 years or more was protective against cataract surgery in the younger age group (50-64 years), while shorter-term use (<5 years) was associated with an increased risk of surgery in both the younger and older age groups (60+ years).
The current study finds that recent longer-tem statin use was protective against cataract surgery in younger patients (50-64 years of age), while shorter-term use was associated with an increased risk of surgery. One strength of the current study is information on the large number of incident cases of cataract extraction and the electronic database on drug use. Additional studies will be needed to understand the difference in effect between longer- and shorter-term users of statins.
研究他汀类药物是否降低白内障摘除的风险。
病例对照研究。
设定:凯撒永久南加州,通过 6000 名医生为 320 万居民提供预付医疗保健。患者人群:符合条件的患者是那些在 2009 年有 5 年以上连续入组的患者。病例为 2009 年第一只眼接受白内障手术的 13982 名患者。对照组是 34049 名接受眼部检查但未行白内障手术或病历中无白内障诊断的患者。观察程序:评估白内障手术、他汀类药物治疗和其他危险因素的主要数据源是 Kaiser Permanente 的电子数据库。主要观察指标:他汀类药物的使用。
接受白内障手术的患者年龄较大,更可能是白人,且似乎患有更多的冠状动脉疾病,但糖尿病较少。白内障手术患者使用他汀类药物的比例(64.3%)似乎高于无白内障或白内障手术诊断的患者(55.5%)。在调整年龄、性别、种族、吸烟状况、糖尿病和冠状动脉疾病后,发现长期使用他汀类药物可预防白内障摘除(OR:0.93,P =.02),而短期使用则与白内障手术相关(OR:1.11,P <.0001)。分层逻辑回归分析显示,5 年或以上的他汀类药物使用对 50-64 岁的年轻患者白内障手术有保护作用,而短期使用(<5 年)与年轻和老年患者手术风险增加相关(60+岁)。
本研究发现,近期长期使用他汀类药物可预防年轻患者(50-64 岁)白内障手术,而短期使用与手术风险增加相关。本研究的一个优势是关于大量白内障摘除的新发病例和药物使用的电子数据库的信息。需要进一步的研究来了解他汀类药物的长期和短期使用者之间的效果差异。