目的:本研究的目的是评估使用降脂药与诊断的干眼病(DED)风险之间的关系。
方法:本回顾性研究,病例对照研究纳入了2002-2016年接受降脂药治疗的780,786例患者,其中17,409例在≥2年随访期间新诊断为DED.这些患者与对照组参与者的年龄为1:4,性别,和合并症。分别计算DED和他汀类药物和贝特类药物的比值比(OR)。
结果:他汀类药物使用者的DED几率(校正OR=1.12;95%置信区间(CI)=1.08-1.16,p<0.0001)明显高于非使用者。固定使用者并未显示出比非使用者更高的DED几率(调整后的OR=1.04;95%CI=0.99-1.10,p=0.125)。与亲水性他汀类药物使用者相比,亲脂性他汀类药物使用者并未显示出更高的DED几率(校正OR=0.99,95%CI=0.93-1.06,p=0.729)。在他汀类药物使用者中,接受他汀类药物治疗>180天的患者与接受他汀类药物治疗的患者之间发生DED的几率没有显着差异。≤90天或接受他汀类药物治疗91-180天的患者与≤90天(分别调整OR=1.00,p=0.922;调整OR=0.94,p=0.541)。DED的几率在接受低强度,中等强度,和高强度的他汀类药物治疗。
结论:接受他汀类药物治疗的患者比不接受他汀类药物治疗的患者有更高的DED风险。他汀类药物的类型,持续时间,他汀类药物使用强度与DED风险无显著相关.需要进一步的研究来确定他汀类药物与DED风险相关的相关因素。
OBJECTIVE: The purpose of this study is to evaluate the association between lipid-lowering agent use and the risks of diagnosed dry eye disease (DED).
METHODS: This retrospective,
case-control study included 780 786 patients who received lipid-lowering agents in 2002-2016, of which 17 409 were newly diagnosed with DED during a ≥2-year follow-up period. These patients were matched 1:4 with control participants for age, sex, and comorbidities. Separate odds ratios (OR) were calculated for DED and each of statin and fibrate use.
RESULTS: Statin users had significantly higher odds of DED (adjusted OR = 1.12; 95% confidence interval (CI) = 1.08-1.16, p < 0.0001) than nonusers. Fibrate users did not show higher odds of DED than nonusers (adjusted OR = 1.04; 95% CI = 0.99-1.10, p = 0.125). The lipophilic statin users did not show higher odds of DED compared with the hydrophilic statin users (adjusted OR = 0.99, 95% CI = 0.93-1.06, p = 0.729). Among statin users, the odds of DED did not differ significantly between patients receiving statin therapy for >180 days vs. ≤90 days or patients receiving statin therapy for 91-180 days vs. ≤90 days (adjusted OR = 1.00, p = 0.922; adjusted OR = 0.94, p = 0.541, respectively). The odds of DED were not statistically different among patients receiving low-intensity, moderate-intensity, and high-intensity of statin therapy.
CONCLUSIONS: Patients receiving statin therapy had a higher DED risk than patients not receiving statin therapy. The type of statin, the duration, and the intensity of statin use were not significantly associated with DED risks. Further studies are required to identify the relevant factors related to DED risks with statin.