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他汀类药物的使用与白内障风险:加拿大和美国 2 个人群的巢式病例对照研究。

Statin use and risk for cataract: a nested case-control study of 2 populations in Canada and the United States.

机构信息

Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Can J Cardiol. 2014 Dec;30(12):1613-9. doi: 10.1016/j.cjca.2014.08.020.

Abstract

BACKGROUND

In current literature the association between statin use and cataracts is inconsistent and controversial. We sought to further examine the effect of statin use on the risk of cataract and need for surgical intervention in 2 North American populations.

METHODS

This retrospective nested case-control study derived data from the British Columbia (BC) Ministry of Health databases from 2000-2007 and the IMS LifeLink database from 2001-2011 to form 2 patient cohorts. The BC cohort was comprised of female and male patients; 162,501 patients were matched with 650,004 control subjects. The IMS LifeLink cohort was comprised of male patients aged 40-85 years; 45,065 patients were matched with 450,650 control subjects. Patients with statin use for > 1 year before the initial ophthalmology visit were identified. Diagnosis and surgical management of cataract were followed. Conditional logistic regression models were used to analyze data.

RESULTS

For the BC cohort, the crude rate ratio (RR) for use of any statin was 1.30, and the adjusted RR was 1.27 (95% confidence interval, 1.24-1.30). The adjusted RRs for each individual statin were all statistically significant. For the IMS LifeLink cohort, the crude RR for use of any statin was 1.13, and the adjusted RR was 1.07 (95% confidence interval, 1.04-1.10).

CONCLUSIONS

This study demonstrates that statin use is significantly associated with cataract requiring surgical intervention. This relationship was consistent in both North American cohorts. Further assessment of this relationship is recommended, especially because of increased statin use and the importance of acceptable vision in old age when cardiovascular disease is common.

摘要

背景

目前的文献中,他汀类药物的使用与白内障之间的关联并不一致,存在争议。我们试图在 2 个北美人群中进一步研究他汀类药物的使用与白内障风险和手术干预需求之间的关系。

方法

这项回顾性巢式病例对照研究的数据来自不列颠哥伦比亚省(BC)卫生部数据库(2000-2007 年)和 IMS LifeLink 数据库(2001-2011 年),以形成 2 个患者队列。BC 队列由女性和男性患者组成;162501 名患者与 650004 名对照匹配。IMS LifeLink 队列由 40-85 岁的男性患者组成;45065 名患者与 450650 名对照匹配。确定了在首次眼科就诊前使用他汀类药物超过 1 年的患者。对白内障的诊断和手术治疗进行随访。采用条件逻辑回归模型分析数据。

结果

对于 BC 队列,任何他汀类药物的使用的粗率比(RR)为 1.30,调整后的 RR 为 1.27(95%置信区间,1.24-1.30)。每种他汀类药物的调整后 RR 均具有统计学意义。对于 IMS LifeLink 队列,任何他汀类药物的使用的粗 RR 为 1.13,调整后的 RR 为 1.07(95%置信区间,1.04-1.10)。

结论

这项研究表明,他汀类药物的使用与需要手术干预的白内障显著相关。这一关系在两个北美队列中均一致。建议进一步评估这种关系,特别是由于他汀类药物的使用增加以及心血管疾病常见时老年人对可接受视力的重视。

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