David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, USA.
Doheny Eye Institute, Pasadena, CA, USA.
Graefes Arch Clin Exp Ophthalmol. 2023 Aug;261(8):2245-2255. doi: 10.1007/s00417-023-06017-0. Epub 2023 Mar 14.
This study evaluated the relationship between statin use and the age of onset of age-related macular degeneration (AMD).
Electronic Health Records from 52,840 patients evaluated at University of California Los Angeles (UCLA) Ophthalmology Clinics and 9,977 patients evaluated at University of California San Francisco (UCSF) Ophthalmology Clinics were screened. Survival analysis was performed using Cox proportional hazards regression models and visualized using Kaplan Meier survival curves, with the following covariates-sex, ethnicity, smoking history, fluoxetine use, obesity, diabetes mellitus, and hypertension.
5,498 of 52,840 patients at UCLA were diagnosed with AMD. Statin use was associated with a later AMD onset (HR = 0.8823, p < 0.0001), while female sex (HR = 1.0852, p= 00,035), obesity (HR = 1.4555, p < 0.0001), and fluoxetine (HR = 1.3797, p= 0.0003) were associated with an earlier AMD onset. Non-hispanic black (HR = 0.5687, p < 0.0001) and hispanic ethnicities (HR = 0.8269, p= 0.0028) were associated with a later AMD onset. When stratifying for ethnicity, statins, fluoxetine, sex, and obesity were significant only within non-hispanic white subjects. Statin use was significant among patients with dry AMD (HR = 0.8410, p= 0.0001) but not wet AMD (0.9188, p= 0.0351). In the replication cohort, 526 of 9,977 patients at UCSF had AMD. Associations between statins (HR = 0.7643, p= 0.0033), non-hispanic black ethnicity (HR = 0.5043, p= 0.0035), and obesity (HR = 1.9602, p < 0.0001) on AMD onset were confirmed.
In both cohorts, statin use and non-hispanic black ethnicity are associated with a later AMD onset, while obesity with an earlier AMD onset.
本研究评估了他汀类药物的使用与年龄相关性黄斑变性（AMD）发病年龄之间的关系。
筛选了加利福尼亚大学洛杉矶分校（UCLA）眼科诊所 52840 名患者和加利福尼亚大学旧金山分校（UCSF）眼科诊所 9977 名患者的电子健康记录。使用 Cox 比例风险回归模型进行生存分析，并使用 Kaplan-Meier 生存曲线进行可视化，同时考虑了以下协变量：性别、种族、吸烟史、氟西汀使用、肥胖、糖尿病和高血压。
在 UCLA 的 52840 名患者中，有 5498 名被诊断为 AMD。他汀类药物的使用与 AMD 发病较晚相关（HR=0.8823，p<0.0001），而女性（HR=1.0852，p=0.035）、肥胖（HR=1.4555，p<0.0001）和氟西汀（HR=1.3797，p=0.0003）与 AMD 发病较早相关。非西班牙裔黑人和西班牙裔与 AMD 发病较晚相关（HR=0.5687，p<0.0001；HR=0.8269，p=0.0028）。在按种族分层时，他汀类药物、氟西汀、性别和肥胖仅在非西班牙裔白种人群中具有统计学意义。他汀类药物在干性 AMD 患者中具有统计学意义（HR=0.8410，p=0.0001），但在湿性 AMD 患者中无统计学意义（0.9188，p=0.0351）。在复制队列中，UCSF 的 9977 名患者中有 526 名患有 AMD。他汀类药物（HR=0.7643，p=0.0033）、非西班牙裔黑人种族（HR=0.5043，p=0.0035）和肥胖（HR=1.9602，p<0.0001）与 AMD 发病之间的关联得到证实。
在两个队列中，他汀类药物的使用和非西班牙裔黑人种族与 AMD 发病较晚相关，而肥胖与 AMD 发病较早相关。
