Lipid-lowering medication is associated with decreased risk of diabetic retinopathy and the need for treatment in patients with type 2 diabetes: A real-world observational analysis of a health claims database.
AIMS: Fenofibrate and statins reduced the need for diabetic retinopathy (DR)-related treatment in clinical trials. We aimed to determine whether use of lipid-lowering medication reduces the risk of DR and the need for treatment in patients with type 2 diabetes using a real-world health claims database.
METHODS: This was an observational analysis using a nation-wide health claims database of the Japan Medical Data Center (JMDC). Type 2 diabetes was defined according to ICD-10 codes for use of glucose-lowering medication. Use of lipid-lowering medication for at least 1 year was confirmed by the Anatomical Therapeutic Chemical Classification System. DR and diabetic macular edema (DME) were determined by ICD-10 codes. DR-related treatments were determined by health insurance claims. A propensity score for use of lipid-lowering medication was estimated, and a doubly robust estimator, using the inverse probability weighting model with regression adjustment, was obtained to determine odds ratios (OR) with 95% confidence interval (95% CI) for cumulative incidence of DR and its treatments over 3 years.
RESULTS: There were 69 070 individuals with type 2 diabetes at baseline, among whom DR developed in 5687 over a period of 3 years. Use of lipid-lowering medication was associated with decreased risk of incidence of DR (OR, 0.772; 95% CI, 0.720-0.827; P < .001). Use of lipid-lowering medication was also associated with decreased incidence of DME, any treatments for DR, laser photocoagulation and vitrectomy in patients with DR at baseline.
CONCLUSIONS: In a population of patients with type 2 diabetes with a variety of risk profiles, use of lipid-lowering medication reduced the risk of DR and thus the risks involved in treatment with laser photocoagulation and vitrectomy.
|ジャーナル名||Diabetes, obesity & metabolism|
|投稿者||Kawasaki, Ryo; Konta, Tsuneo; Nishida, Kohji|
|組織名||Department of Public Health and Hygiene, Yamagata University Faculty of Medicine,;Yamagata, Japan.;Department of Vision Informatics (Topcon), Osaka University Graduate School of;Medicine, Osaka, Japan.;Department of Clinical Research, Faculty of Health Sciences, University of;Southern Denmark, Odense, Denmark.;Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka,;Japan.|