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干眼疾病与血脂异常和他汀类药物使用的关联。

Association of Dry Eye Disease With Dyslipidemia and Statin Use.

机构信息

Department of Ophthalmology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA.

Department of Ophthalmology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA.

出版信息

Am J Ophthalmol. 2020 Oct;218:54-58. doi: 10.1016/j.ajo.2020.05.007. Epub 2020 May 12.

Abstract

PURPOSE

To determine whether an association exists between dry eye disease (DED) and statin use and/or dyslipidemia.

DESIGN

Retrospective, case-control study.

METHODS

Setting: University of North Carolina (UNC)-affiliated healthcare facilities.

STUDY POPULATION

72,931 patients seen at UNC ophthalmology clinics over a 10-year period.

MAIN OUTCOME MEASURES

Odds ratios (ORs) calculated between DED and a history of low, moderate, or high-intensity statin use; and ORs calculated between DED and abnormal lipid panel values.

RESULTS

Total of 39,336 individuals (53.9% female) were analyzed after exclusion of individuals with confounding risk factors for DED. Of these, 3,399 patients (8.6%) carried a diagnosis of DED. Low-, moderate-, and high-intensity statin regimens were used by 751 subjects (1.9%), 2,655 subjects (6.8%), and 1,036 subjects (2.6%). Lipid abnormalities were identified as total cholesterol >200 mg/dL, 4,558 subjects (11.6%); high-density lipoprotein (HDL) <40 mg/dL, 2,078 subjects (5.3%); low-density lipoprotein (LDL) >130 mg/dL, 2,756 subjects (7.0%); and triglycerides (TGs) >150 mg/dL, 2,881 subjects (7.3%). The odds ratios (OR) of carrying a diagnosis of DED given the presence of low-, moderate-, and high-intensity statin use were 1.39 (95% confidence interval [CI]: 1.13-1.72); OR 1.47 (95% CI: 1.30-1.65), and OR 1.46 (95% CI: 1.21-1.75), respectively. The OR of carrying a diagnosis of DED given the presence of total cholesterol >200 mg/dL, HDL <40 mg/dL, LDL >130 mg/dL, and TGs >150 mg/dL were 1.66 (95% CI: 1.52-1.82), 1.45 (95% CI: 1.26-1.67), 1.55 (95% CI: 1.39-1.74), and 1.43 (95% CI: 1.27-1.61), respectively.

CONCLUSIONS

A history of statin use or dyslipidemia is associated with an increased odds of having a DED diagnosis. Further studies are needed to determine whether statin use and/or dyslipidemia increases the risk of DED.

摘要

目的

确定干眼症 (DED) 是否与他汀类药物的使用和/或血脂异常有关。

设计

回顾性病例对照研究。

方法

地点:北卡罗来纳大学 (UNC) 附属医院。

研究人群

在 UNC 眼科诊所就诊的 72931 名患者,就诊时间为 10 年。

主要观察指标

DED 与低、中、高强度他汀类药物使用史之间的比值比 (OR);DED 与异常脂质谱值之间的 OR。

结果

排除 DED 的混杂危险因素后,共分析了 39336 名患者 (53.9%为女性)。其中,3399 名患者 (8.6%)被诊断为 DED。751 名患者 (1.9%)、2655 名患者 (6.8%)和 1036 名患者 (2.6%)分别使用低、中、高强度他汀类药物。4558 名患者 (11.6%)总胆固醇>200mg/dL;2078 名患者 (5.3%)高密度脂蛋白 (HDL)<40mg/dL;2756 名患者 (7.0%)低密度脂蛋白 (LDL)>130mg/dL;2881 名患者 (7.3%)甘油三酯 (TG)>150mg/dL。存在低、中、高强度他汀类药物使用时,DED 诊断的比值比 (OR)分别为 1.39 (95%置信区间 [CI]:1.13-1.72);OR 1.47 (95% CI:1.30-1.65),OR 1.46 (95% CI:1.21-1.75)。存在总胆固醇>200mg/dL、HDL<40mg/dL、LDL>130mg/dL 和 TGs>150mg/dL 时,DED 诊断的比值比分别为 1.66 (95% CI:1.52-1.82)、1.45 (95% CI:1.26-1.67)、1.55 (95% CI:1.39-1.74)和 1.43 (95% CI:1.27-1.61)。

结论

他汀类药物使用史或血脂异常与 DED 诊断的几率增加有关。需要进一步研究以确定他汀类药物使用和/或血脂异常是否会增加 DED 的风险。

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