Machan Carolyn M, Hrynchak Patricia K, Irving Elizabeth L
School of Optometry, University of Waterloo, Waterloo, Ontario, Canada.
Optom Vis Sci. 2012 Aug;89(8):1165-71. doi: 10.1097/OPX.0b013e3182644cd1.
Diabetes has been shown to be a risk factor for age-related (AR) cataract. As statins (HMG-CoA reductase inhibitors) are now commonly prescribed for patients with type 2 diabetes, their impact on AR cataract prevalence should be considered. This study determines associations between AR cataract, type 2 diabetes, and reported statin use in a large optometric clinic population.
In all, 6397 patient files (ages <1-93 years) were reviewed. Overall prevalence of statin use was calculated for patients with type 2 diabetes (n = 452) and without diabetes (n = 5884). Multivariable logistic regression analysis for AR cataract was performed controlling for patient sex, smoking, high blood pressure, type 2 diabetes, and statin use.
The prevalence of statin use (in patients aged >38 years) was 56% for those with type 2 diabetes and 16% for those without diabetes. Type 2 diabetes was significantly associated with nuclear sclerosis (OR = 1.62, 1.14-2.29) and cortical cataract (OR = 1.37, 1.02-1.83). Statin use was associated with nuclear sclerosis (OR = 1.48, 1.09-2.00) and posterior subcapsular cataract (OR = 1.48, 1.07-2.04). The 50% probability of cataract in statin users occurred at age 51.7 and 54.9 years in patients with type 2 diabetes and without diabetes, respectively. In non-statin users, it was significantly later at age 55.1 and 57.3 years for patients with type 2 diabetes and without diabetes, respectively (p < 0.001).
In this population, statin use was substantially higher in patients with type 2 diabetes and was associated with AR cataracts. Further long-term study is warranted to recommend monitoring of crystalline lenses in patients with type 2 diabetes benefiting from statins.
糖尿病已被证明是年龄相关性（AR）白内障的一个危险因素。由于他汀类药物（HMG-CoA还原酶抑制剂）目前常用于2型糖尿病患者，因此应考虑其对AR白内障患病率的影响。本研究确定了在一个大型验光诊所人群中AR白内障、2型糖尿病和报告的他汀类药物使用之间的关联。
共查阅了6397份患者档案（年龄1 - 93岁）。计算了2型糖尿病患者（n = 452）和非糖尿病患者（n = 5884）中他汀类药物使用的总体患病率。对AR白内障进行多变量逻辑回归分析，控制患者性别、吸烟、高血压、2型糖尿病和他汀类药物使用情况。
2型糖尿病患者（年龄>38岁）中他汀类药物使用的患病率为56%，非糖尿病患者为16%。2型糖尿病与核性硬化（OR = 1.62，1.14 - 2.29）和皮质性白内障（OR = 1.37，1.02 - 1.83）显著相关。他汀类药物使用与核性硬化（OR = 1.48，1.09 - 2.00）和后囊下白内障（OR = 1.48，1.07 - 2.04）相关。他汀类药物使用者患白内障的50%概率在2型糖尿病患者中为51.7岁，在非糖尿病患者中为54.9岁。在非他汀类药物使用者中，2型糖尿病患者和非糖尿病患者患白内障的概率分别显著延迟至55.1岁和57.3岁（p < 0.001）。
在该人群中，2型糖尿病患者他汀类药物的使用显著更高，且与AR白内障相关。有必要进行进一步的长期研究，以建议对受益于他汀类药物的2型糖尿病患者的晶状体进行监测。
