Department of Ophthalmology & Visual Science, University of Chicago Pritzker School of Medicine, Chicago, Illinois.
The Retina Institute, St. Louis, Missouri; and.
Retina. 2024 Feb 1;44(2):205-213. doi: 10.1097/IAE.0000000000003968.
To investigate if metformin use reduces the odds of developing new neovascular AMD (nAMD).
This is a case-control study of 86,930 subjects with new diagnoses of nAMD and 86,918 matched control subjects using the Merative Marketscan Research Databases. Subjects were analyzed using multivariable conditional logistic regression to identify the risks of various exposures on developing nAMD. A subgroup analysis of 22,117 diabetic cases and 21,616 diabetic control subjects was also performed.
Metformin use was associated with reduced odds ratio of developing nAMD (odds ratio 0.95, 95% confidence interval 0.91-0.98) in full sample and diabetic cohort particularly in patients without any diabetic retinopathy-an effect that persisted after Bonferroni correction. In the diabetic cohort without diabetic retinopathy, reduced odds ratio was observed at 24-month cumulative doses of 1 to 300 g, 301 to 630 g, and 631 to 1,080 g.
Metformin use was associated with reduced odds ratio of nAMD, particularly in patients without diabetic retinopathy. The protective effect was noted for 24-month cumulative doses below 1,080 g. Metformin may be a novel preventive strategy for nAMD.
研究二甲双胍的使用是否降低了新发新生血管性年龄相关性黄斑变性（nAMD）的风险。
这是一项使用 Merative Marketscan 研究数据库的 86930 例新发 nAMD 患者和 86918 例匹配对照患者的病例对照研究。使用多变量条件逻辑回归分析方法，对各种暴露因素发生 nAMD 的风险进行分析。还对 22117 例糖尿病患者和 21616 例糖尿病对照患者进行了亚组分析。
在全样本和糖尿病队列中，二甲双胍的使用与降低发生 nAMD 的比值比相关（比值比 0.95，95%置信区间 0.91-0.98），特别是在没有任何糖尿病视网膜病变的患者中，这一效果在经过 Bonferroni 校正后仍然存在。在没有糖尿病视网膜病变的糖尿病队列中，观察到在 24 个月累积剂量为 1 至 300 克、301 至 630 克和 631 至 1080 克时，比值比降低。
二甲双胍的使用与 nAMD 的比值比降低相关，特别是在没有糖尿病视网膜病变的患者中。在累积剂量低于 1080 克的 24 个月内观察到了保护作用。二甲双胍可能是预防 nAMD 的一种新策略。
