Thomson Kyle B, Khalid Syed I, Sabherwal Naryan, Heiferman Michael J
Office of Medical Education, Chicago Medical School, North Chicago, IL, USA.
Department of Neurosurgery, University of Illinois Chicago, Chicago, IL, USA.
J Vitreoretin Dis. 2024 Aug 31:24741264241269479. doi: 10.1177/24741264241269479.
To explore the effect of cigarette smoking on the risk for developing diabetic macular edema (DME) among patients with diabetes. This retrospective exactly-matched cohort study used claims data for patients from all 50 states in the United States from 2010 through 2020. Patients with an initial diagnosis of diabetes were stratified into 3 cohorts as follows: active smokers, never smokers, and former smokers. After exact matching based on demographics and comorbidities, Kaplan-Meier survival functions for the 3 cohorts were compared using pairwise log-rank tests. After matching, there were 42 298 patients in each cohort. Over 6 years of follow-up, the cumulative risk for DME was significantly higher among never smokers (1.18%) than among active smokers (0.88%) and former smokers (0.90%) (both < .001). Among patients with diabetes, smoking may decrease the risk for developing DME. Although the harms of smoking far outweigh any potential protective benefits, further investigation into the mechanisms behind these findings has potential to uncover new therapeutic targets.
为探讨吸烟对糖尿病患者发生糖尿病性黄斑水肿（DME）风险的影响。这项回顾性精确匹配队列研究使用了2010年至2020年美国所有50个州患者的理赔数据。初诊为糖尿病的患者被分为3个队列，如下：现吸烟者、从不吸烟者和既往吸烟者。在根据人口统计学和合并症进行精确匹配后，使用成对对数秩检验比较了3个队列的Kaplan-Meier生存函数。匹配后，每个队列有42298名患者。在6年的随访中，从不吸烟者中DME的累积风险（1.18%）显著高于现吸烟者（0.88%）和既往吸烟者（0.90%）（两者均<0.001）。在糖尿病患者中，吸烟可能会降低发生DME的风险。尽管吸烟的危害远超过任何潜在的保护益处，但对这些发现背后机制的进一步研究有可能揭示新的治疗靶点。
