Association of Statin Use With Cataracts A Propensity Score-Matched Analysis
Association of Statin Use With Cataracts A Propensity Score-Matched Analysis
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DOI：
10.1001/jamaophthalmol.2013.4575
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发表时间：
2013-11-01
影响因子：
8.1
通讯作者：
Mansi, Ishak
中科院分区：
文献类型：
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作者：
Leuschen, Jessica;Mortensen, Eric M.;Mansi, Ishak
白内障是导致低视力的主要原因;随着老年人口的增长，白内障的发病率可能会增加。研究人员以前曾假设，他汀类抗氧化剂的作用可能会减缓自然老化过程的透镜.OBJECTIVE比较他汀类药物使用者和nonusers.DESIGN之间的发展白内障的风险倾向评分匹配队列分析使用回顾性数据从2003年10月1日，2010年3月1日。使用44个变量建立了他汀类药物使用者和非使用者的倾向评分匹配队列。设置军事卫生保健系统的数据库。参与者基于2005财政年度期间的药物填充，患者被分为2组：（1）他汀类药物使用者（接受至少90天的他汀类药物供应）和（2）非使用者（在整个研究中从未接受过他汀类药物）。在46 249例符合研究标准的患者中，我们确定了13 626名他汀类药物使用者和32 623名非使用者。暴露使用他汀类药物治疗超过90 days.Main结局和指标主要分析检查了倾向评分匹配队列中白内障的风险。次要分析根据Charlson合并症指数（无Charlson合并症的患者）检查了无合并症患者的白内障风险。进行敏感性分析，重复二次分析的患者服用他汀类药物的持续时间为2，4，和6 years.RESULTS为我们的主要分析，我们匹配6972对他汀类药物使用者和非使用者。在倾向评分匹配队列中，他汀类药物使用者发生白内障的风险高于非使用者（比值比，1.09; 95%CI，1.02-1.17）。在二次分析中，在调整确定的混杂因素后，他汀类药物使用者的白内障发病率高于非使用者（比值比，1.27; 95%CI，1.15-1.40）。敏感性分析证实了这种关系。结论和相关性白内障的风险增加，他汀类药物使用者相比，非用户。他汀类药物使用的风险-效益比，特别是用于一级预防，应仔细权衡，并保证进一步的研究。
IMPORTANCE Cataracts are a main cause of low vision; with the growing elderly population, the incidence of cataracts is likely to increase. Investigators have previously hypothesized that statin antioxidant effects may slow the natural aging process of the lens.OBJECTIVE To compare the risks for development of cataracts between statin users and nonusers.DESIGN A propensity score-matched cohort analysis using retrospective data from October 1, 2003, to March 1, 2010. A propensity score-matched cohort of statin users and nonusers was created using 44 variables.SETTING Database of a military health care system.PARTICIPANTS Based on medication fills during fiscal year 2005, patients were divided into 2 groups: (1) statin users (received at least a 90-day supply of statin) and (2) nonusers (never received a statin throughout the study). Among 46 249 patients meeting study criteria, we identified 13 626 statin users and 32 623 nonusers.EXPOSURE Use of statin therapy for more than 90 days.MAIN OUTCOMES AND MEASURES Primary analysis examined the risks for cataract in the propensity score-matched cohort. Secondary analyses examined the risks for cataract in patients with no comorbidities according to the Charlson Comorbidity Index (patients with no Charlson comorbidity). A sensitivity analysis was conducted to repeat the secondary analysis in patients taking statins for durations of 2, 4, and 6 years.RESULTS For our primary analysis, we matched 6972 pairs of statin users and nonusers. The risk for cataract was higher among statin users in comparison with nonusers in the propensity score-matched cohort (odds ratio, 1.09; 95% CI, 1.02-1.17). In secondary analyses, after adjusting for identified confounders, the incidence of cataract was higher in statin users in comparison with nonusers (odds ratio, 1.27; 95% CI, 1.15-1.40). Sensitivity analysis confirmed this relationship.CONCLUSIONS AND RELEVANCE The risk for cataract is increased among statin users as compared with nonusers. The risk-benefit ratio of statin use, specifically for primary prevention, should be carefully weighed, and further studies are warranted.