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

Kawasaki, Ryo; Konta, Tsuneo; Nishida, Kohji

doi:10.1111/dom.13372

Cited by 52 publications

(39 citation statements)

References 32 publications

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“…Total-to-HDL (high-density lipoproteins) ratio and LDL (low-density lipoproteins) have also been shown to be significant risk factors for the development of DME [5]. Consistent with these findings, in a recent study using a health claims database, lipid-lowering medication use was associated with a decreased incidence of DME [6]. Other potential systemic risk factors for DME include age, sleep apnea, pregnancy, anemia, lack of glycemic control, duration of diabetes, nephropathy/microalbuminuria, systemic fluid retention in congestive heart failure or renal disease, and use of the glitazone (thiazolidinedione) class of oral antihyperglycemic medications [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 65%

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Natural history of diabetic macular edema and factors predicting outcomes in sham-treated patients (MEAD study)

Yoon¹,

Boyer²,

Maturi³

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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Purpose To describe the natural history of diabetic macular edema (DME) with respect to best-corrected visual acuity (BCVA) and central retinal thickness (CRT) outcomes and to identify baseline patient characteristics and systemic factors associated with improvement or worsening of outcomes in sham-treated patients. Methods The study population was sham-treated patients (n = 350) in the 3-year MEAD registration study of dexamethasone intravitreal implant for treatment of DME. Patients had center-involved DME and received sham intravitreal injections in the study eye at ≥ 6-month intervals. Potential prognostic factors for outcomes were evaluated using multiple linear regression analysis. Results Visual and anatomic outcomes were poorer in patients who left the study early (n = 198) than in study completers (n = 152). Mean change in BCVA from baseline at the last visit with available data was + 0.9 letters; 37.5% of patients had no change in BCVA, 23.2% had gained > 10 letters, and 16.0% had lost > 10 letters. Older age and baseline diabetic retinopathy score > 6 were associated with worse BCVA outcomes; thicker baseline CRT and larger number of hypertension medications used were associated with larger reductions in CRT during the study. Conclusions BCVA and CRT outcomes were variable in this population of DME patients with generally good glycemic control. In DME patients without active treatment, older age and baseline diabetic retinopathy score > 6 were associated with less improvement in BCVA; thicker baseline CRT and a larger number of antihypertensive medications used predicted better improvement in CRT. Trial registration The MEAD study trials are registered at ClinicalTrials.gov with the identifiers NCT00168337 and NCT00168389. Keywords Diabetic macular edema. Natural history. Prognosis. Risk factors. Visual acuity MEAD study group members are listed in Appendix 1.

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Section: Introductionmentioning

confidence: 65%

“…There is evidence of a possible association between serum lipids and DME [4,5], and studies have further suggested that use of lipid-lowering medications might reduce the incidence of DME [6,28]. A study in 1011 patients with type 2 diabetes showed a relationship between lipid profiles and HbA1c levels [29].…”

Section: Discussionmentioning

confidence: 99%

Natural history of diabetic macular edema and factors predicting outcomes in sham-treated patients (MEAD study)

Yoon¹,

Boyer²,

Maturi³

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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“…A study assessed the effects of atorvastatin on diabetic retinopathy found no difference between the drug and the placebo arms 11 Nielsen et al 12 in their retrospective study found that statins could prevent retinopathy even before the development of diabetes, another retrospective study from South Korea 13 showed that statins decreased macular oedema and retinopathy. An observational analysis from Japan 14 included 69,070 patients followed for three years found that statins decreased diabetic retinopathy, and a review conducted on statins effect on various eye disorders 15 concluded that statins decreased macular oedema and progression of diabetic retinopathy. However, the broad review aims, the search in only one database, and the narrative nature may not give solid evidence regarding the conclusion, another well-designed recent review and metaanalysis concluded the uncertainty regarding the association of statin and diabetic retinopathy.…”

Section: Discussionmentioning

confidence: 99%

The relationship between statins and diabetic retinopathy: A review of literature

Alali¹,

ALBalawi²,

Mirghani³

2020

amj

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Background Treatment with statins is a robust strategy in reducing cardiovascular complications among patients with diabetes mellitus and chronic kidney disease. There is an increasing awareness regarding the association of statins with diabetic retinopathy. Aims The current review aimed to assess the relationship of statins therapy to diabetic retinopathy. Methods The literature in PubMed and Google Scholar was searched for relevant articles from the first available article up to present using the terms statins, simvastatin, atorvastatin, pravastatin, and diabetic retinopathy. Among the 169 articles retrieved, 26 full-texts were assessed for eligibility and only sixteen studies (four from the USA, another four from Europe, six from Asia, and one from Australia and Brazil each) met the inclusion criteria for the systematic review. The author name, year of publication, country, type of study, number of patients, and the duration of the study were reported. Results The studies reviewed showed that statins reduce the development of diabetic retinopathy, retard the progression of hard exudates and micro-aneurisms, reduce retinopathy and macular oedema. Conclusion Statins prevent and reduce the progression of diabetic retinopathy and macular oedema.

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“…Study design and data source. This study is a retrospective observational analysis using the health claims database of the Japan Medical Data Center (JMDC; Tokyo, Japan) between January 2005 and August 2018 [27][28][29][30][31][32] . The JMDC contracts with more than 60 insurers and includes data for health insurance claims on more than 5 million registered individuals.…”

Section: Methodsmentioning

confidence: 99%

Restfulness from sleep and subsequent cardiovascular disease in the general population

Kaneko

Itoh

Kohno

et al. 2020

Sci Rep

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We aimed to clarify the association between restfulness from sleep and subsequent risk of cardiovascular disease (CVD). Medical records of 1,980,476 individuals with neither prior history of CVD nor sleep disorders were extracted from the Japan Medical Data Center. Restfulness from sleep was subjectively assessed using information from the questionnaires at initial health check-ups. The mean age was 45 ± 11 years and 1,184,937 individuals were men. Overall, 1,197,720 individuals (60.5%) reported having good restfulness from sleep. The mean follow-up period was 1122 ± 827 days. Myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation occurred in 3673 (0.2%), 30,241 (1.5%), 13,546 (0.7%), 28,296 (1.4%), and 8116 (0.4%) individuals, respectively. Multivariable Cox regression analyses including age, sex, and other CVD risk factors after multiple imputation for missing values showed that good restfulness from sleep was associated with lower incidence of myocardial infarction (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.83–0.95), angina pectoris (HR 0.85, 95% CI 0.83–0.87), stroke (HR 0.85, 95% CI 0.82–0.88), heart failure (HR 0.86, 95% CI 0.84–0.88), and atrial fibrillation (HR 0.93, 95% CI 0.89–0.97). The association of restfulness from sleep with CVD events was pronounced in subjects with younger age and female sex. In conclusion, good restfulness from sleep may be associated with the lower risk of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation. Further studies are required to clarify the underlying mechanism and to develop a novel preventive approach for CVD from the perspective of sleep.

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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

Abstract: 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.

Cited by 52 publications

References 32 publications

Natural history of diabetic macular edema and factors predicting outcomes in sham-treated patients (MEAD study)

Natural history of diabetic macular edema and factors predicting outcomes in sham-treated patients (MEAD study)

The relationship between statins and diabetic retinopathy: A review of literature

Restfulness from sleep and subsequent cardiovascular disease in the general population

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