Chung Jui-Fu, Yang Po-Jen, Chang Chao-Kai, Lee Chia-Yi, Huang Jing-Yang, Wang Kai, Yang Shun-Fa
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
Arch Med Sci. 2024 Feb 26;20(2):402-409. doi: 10.5114/aoms/174228. eCollection 2024.
To survey the potential correlation between the application of sodium-glucose cotransporter 2 (SGLT2) inhibitors and the incidence of uveitis in individuals with type 2 diabetes mellitus (T2DM).
A retrospective cohort study using the National Health Insurance Research Database (NHIRD) was conducted. The T2DM patients using SGLT2 inhibitors and those taking other anti-diabetic medications were assigned to the SGLT2 group and the control group, respectively, with a 1 : 2 ratio via the propensity score-matching (PSM) method. The major outcome in this study is the development of uveitis according to the diagnostic codes. The Cox proportional hazard regression was adopted to yield the adjusted hazard ratio (aHR) with 95% confidence interval (CI) between the groups.
There were 147 and 371 new uveitis episodes in the SGLT2 and control groups after the follow-up period up to 5 years. The incidence of uveitis in the SGLT2 group (aHR = 0.736, 95% CI: 0.602-0.899, = 0.0007) was significantly lower than that in the control group after adjusting for the effect of all the confounders. In the subgroup analyses, the SGLT2 inhibitors showed a higher correlation with low uveitis incidence in T2DM patients aged under 50 than T2DM individuals aged over 50 years ( = 0.0012), while the effect of SGLT2 inhibitors on the incidence of anterior and posterior uveitis development was similar ( = 0.7993).
The use of SGLT2 inhibitors could be an independent protective factor for uveitis development in T2DM population.
探讨2型糖尿病（T2DM）患者应用钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂与葡萄膜炎发病率之间的潜在相关性。
采用国家健康保险研究数据库（NHIRD）进行回顾性队列研究。使用SGLT2抑制剂的T2DM患者和服用其他抗糖尿病药物的患者分别通过倾向得分匹配（PSM）方法以1:2的比例被分配到SGLT2组和对照组。本研究的主要结局是根据诊断编码确定的葡萄膜炎的发生情况。采用Cox比例风险回归分析得出两组之间的调整后风险比（aHR）及95%置信区间（CI）。
在长达5年的随访期后，SGLT2组和对照组分别有147例和371例新发葡萄膜炎病例。在调整所有混杂因素的影响后，SGLT2组葡萄膜炎的发病率（aHR = 0.736，95%CI：0.602 - 0.899，P = 0.0007）显著低于对照组。在亚组分析中，SGLT2抑制剂在50岁以下的T2DM患者中与较低的葡萄膜炎发病率相关性更高，高于50岁以上的T2DM患者（P = 0.0012），而SGLT2抑制剂对前葡萄膜炎和后葡萄膜炎发病的影响相似（P = 0.7993）。
在T2DM人群中，使用SGLT2抑制剂可能是葡萄膜炎发生的一个独立保护因素。
