Lin Tai-Chi, Hwang De-Kuang, Hsu Chih-Chien, Peng Chi-Hsien, Wang Mong-Lien, Chiou Shih-Hwa, Chen Shih-Jen
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
PLoS One. 2017 Nov 14;12(11):e0188136. doi: 10.1371/journal.pone.0188136. eCollection 2017.
Previous studies have found that metformin can reduce cardiovascular risk, but its association with retinal vein occlusion (RVO) is unknown. In this population-based cohort study using the Taiwan National Health Insurance Research Database (NHIRD), we demonstrated the protective effect of metformin against RVO in diabetes mellitus (DM) and explored the incidence rate and factors associated with RVO development in general and diabetic populations. One million patients were randomly selected from the registry files of the NHIRD, and all their claims data were collected for the 1996-2011 period. Patients with a new diagnosis of central or branch RVO were identified using International Classification of Disease codes. DM was defined for patients with diagnoses and treatments. Factors associated with RVO development in the non-DM and DM cohorts were explored using Cox proportional regression models. In total, 1,018 RVO patients were identified from the database. The average incidence of RVO was 9.93 and 53.5 cases per 100,000 person-years in the non-DM and DM cohorts, respectively. Older age, DM, hypertension, and glaucoma were significant risk factors for RVO, whereas the prescription of anticoagulants was a significant protective factor. In the DM cohort, older age, hypertension, and diabetic retinopathy were significant risk factors for RVO, whereas metformin treatment was a significant protective factor. These results confirmed the risk factors for RVO and demonstrated the protective effect of metformin against RVO in DM patients. Prescribing metformin for DM patients may be beneficial for reducing the incidence of RVO, along with its hypoglycemic action.
既往研究发现二甲双胍可降低心血管疾病风险，但其与视网膜静脉阻塞（RVO）的关联尚不清楚。在这项基于人群的队列研究中，我们使用台湾国民健康保险研究数据库（NHIRD），证实了二甲双胍对糖尿病（DM）患者RVO具有保护作用，并探讨了普通人群和糖尿病患者中RVO发生的发病率及相关因素。从NHIRD的登记档案中随机选取100万名患者，并收集他们在1996 - 2011年期间的所有理赔数据。使用国际疾病分类代码识别新诊断为中央型或分支型RVO的患者。根据诊断和治疗情况定义DM患者。使用Cox比例回归模型探讨非DM组和DM组中与RVO发生相关的因素。总共从数据库中识别出1018例RVO患者。非DM组和DM组中RVO的平均发病率分别为每10万人年9.93例和53.5例。年龄较大、DM、高血压和青光眼是RVO的显著危险因素，而抗凝剂的使用是显著的保护因素。在DM组中，年龄较大、高血压和糖尿病视网膜病变是RVO的显著危险因素，而二甲双胍治疗是显著的保护因素。这些结果证实了RVO的危险因素，并证明了二甲双胍对DM患者RVO具有保护作用。为DM患者开具二甲双胍可能有利于降低RVO的发病率，同时发挥其降血糖作用。
