Huang Kuang-Hua, Chang Ya-Lan, Lee Chiachi Bonnie, Gau Shuo-Yan, Tsai Tung-Han, Chung Ning-Jen, Lee Chien-Ying
Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan.
Front Pharmacol. 2023 Nov 22;14:1275095. doi: 10.3389/fphar.2023.1275095. eCollection 2023.
Recent studies have demonstrated that patients with type 2 diabetes mellitus (T2DM) who receive metformin have a decreased risk of developing age-related macular degeneration (AMD). However, other studies have also suggested that metformin may increase the risk of AMD development. Therefore, this study investigated the association between treatment with metformin and the risk of AMD in patients with T2DM by using Taiwan' National Health Insurance Research Database. Patients who received a diagnosis of new-onset T2DM between 2002 and 2013 were enrolled in this study. The patients were divided into patients treated and not treated with metformin to evaluate the risk of AMD after 5 years of follow-up. The logistic regression was used to estimate the risk of AMD associated with the intensity of treatment with metformin. A total of 7 517 patients (103.16 patients per 10,000 people) developed AMD in 5 years after DM diagnosis. After adjusting for the relevant variables, patients with T2DM treated with <5 defined daily dose (DDD)/month of metformin had a lower risk of AMD (odds ratios [OR]: 0.93; 95% confidence interval [CI]: 0.88 0.99). Patients treated with >25 DDD/month of metformin had a higher risk of AMD (OR: 1.39; 95% CI: 1.08-1.78). Metformin use may be associated with a risk of AMD among patients with T2DM in a dose-dependent association manner, with the greater benefit at lower DDD/month. However, higher DDD/month exhibited an increased risk of AMD.
近期研究表明，接受二甲双胍治疗的2型糖尿病（T2DM）患者发生年龄相关性黄斑变性（AMD）的风险降低。然而，其他研究也表明，二甲双胍可能会增加AMD发生的风险。因此，本研究利用台湾国民健康保险研究数据库，调查了二甲双胍治疗与T2DM患者发生AMD风险之间的关联。本研究纳入了2002年至2013年间被诊断为新发T2DM的患者。将患者分为接受二甲双胍治疗和未接受二甲双胍治疗的两组，以评估随访5年后发生AMD的风险。采用逻辑回归分析评估与二甲双胍治疗强度相关的AMD风险。共有7517例患者（每10000人中有103.16例）在糖尿病诊断后5年内发生了AMD。在对相关变量进行校正后，二甲双胍治疗剂量<5限定日剂量（DDD）/月的T2DM患者发生AMD的风险较低（比值比[OR]：0.93；95%置信区间[CI]：0.88-0.99）。二甲双胍治疗剂量>25 DDD/月的患者发生AMD的风险较高（OR：1.39；95% CI：1.08-1.78）。二甲双胍的使用可能与T2DM患者发生AMD的风险呈剂量依赖性关联，每月较低的DDD剂量获益更大。然而，每月较高的DDD剂量会增加AMD的风险。
