Addition of fenofibrate to statins is associated with risk reduction of diabetic retinopathy progression in patients with type 2 diabetes and metabolic syndrome: A propensity-matched cohort study |
| |
Affiliation: | 1. Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea;2. Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea |
| |
Abstract: | AimThis study aimed to determine the association between fenofibrate added to statin therapy and diabetic retinopathy progression.MethodsIn this propensity-matched study using the Korean National Health Insurance Service cohort (2002–2019), patients with type 2 diabetes and metabolic syndrome (≥ 30 years) receiving statin therapy were matched 1:2 by propensity score into the statin plus fenofibrate group (n = 22,395) and statin-only group (n = 43,191). The primary outcome was a composite of diabetic retinopathy progression including vitreous hemorrhage, vitrectomy, laser photocoagulation, intravitreous injection therapy and retinal detachment.ResultsThe median (quartiles) follow-up duration was 44.0 (27.6–70.6) months. For the primary outcome, the incidence rate per 1,000 person-years was 9.66 in the statin-only group and 8.68 in the statin-plus-fenofibrate group. The risk of the primary outcome was significantly lower (hazard ratio [HR]=0.88; 95% confidence interval [0.81;0.96] P = 0.005) in the statin-plus-fenofibrate group than in the statin-only group. Only patients with pre-existing retinopathy showed benefits from fenofibrate treatment (HR=0.83 [0.73;0.95] P = 0.006). In addition, the statin plus fenofibrate group exhibited significantly lower risks of vitreous hemorrhage (HR= 0.86 [0.75;0.995] P = 0.042), laser photocoagulation (HR=0.86 [0.77;0.96] P = 0.009) and intravitreous injection therapy (HR=0.73 [0.59;0.90] P = 0.003) than those in the statin-only group. There was no significant interaction between the different characteristics at baseline and the treatment effect.ConclusionThe addition of fenofibrate to statins was associated with significantly lower risk of diabetic retinopathy progression than statin therapy alone in patients with type 2 diabetes and metabolic syndrome. |
| |
Keywords: | T2DM" },{" #name" :" keyword" ," $" :{" id" :" pc_z8QkNouGz0" }," $$" :[{" #name" :" text" ," _" :" type 2 diabetes mellitus VEGF" },{" #name" :" keyword" ," $" :{" id" :" pc_QgLeUZlfHI" }," $$" :[{" #name" :" text" ," _" :" vascular endothelial growth factor PPAR-α" },{" #name" :" keyword" ," $" :{" id" :" pc_ebBscc6B3v" }," $$" :[{" #name" :" text" ," _" :" peroxisome proliferator-activated receptor alpha RCT" },{" #name" :" keyword" ," $" :{" id" :" pc_Eoa2pG8bLK" }," $$" :[{" #name" :" text" ," _" :" randomized clinical trial FIELD" },{" #name" :" keyword" ," $" :{" id" :" pc_wpIgxRZdTr" }," $$" :[{" #name" :" text" ," _" :" Fenofibrate Intervention and Event Lowering in Diabetes ACCORD" },{" #name" :" keyword" ," $" :{" id" :" pc_S1erPSTb2k" }," $$" :[{" #name" :" text" ," _" :" Action to Control Cardiovascular Risk in Diabetes ECLIPSE-REAL" },{" #name" :" keyword" ," $" :{" id" :" pc_XnZqMrVZgu" }," $$" :[{" #name" :" text" ," _" :" Effectiveness of Fenofibrate Therapy in Residual Cardiovascular Risk Reduction in the Real World Setting NHIS" },{" #name" :" keyword" ," $" :{" id" :" pc_08p8YiWDmJ" }," $$" :[{" #name" :" text" ," _" :" National Health Insurance Service ICD-10" },{" #name" :" keyword" ," $" :{" id" :" pc_uhdWk4qmqm" }," $$" :[{" #name" :" text" ," _" :" International Classification of Disease, Tenth Revision WC" },{" #name" :" keyword" ," $" :{" id" :" pc_dQnWvUKh9e" }," $$" :[{" #name" :" text" ," _" :" waist circumference TG" },{" #name" :" keyword" ," $" :{" id" :" pc_Wy85OKv3VD" }," $$" :[{" #name" :" text" ," _" :" triglyceride HDL-C" },{" #name" :" keyword" ," $" :{" id" :" pc_4TNMi2U6xh" }," $$" :[{" #name" :" text" ," _" :" high-density lipoprotein cholesterol BMI" },{" #name" :" keyword" ," $" :{" id" :" pc_K80BDoEwu1" }," $$" :[{" #name" :" text" ," _" :" body mass index LDL-C" },{" #name" :" keyword" ," $" :{" id" :" pc_JfHhc53ns0" }," $$" :[{" #name" :" text" ," _" :" low-density lipoprotein cholesterol SMD" },{" #name" :" keyword" ," $" :{" id" :" pc_ARdnunkrgj" }," $$" :[{" #name" :" text" ," _" :" standardized mean difference HR" },{" #name" :" keyword" ," $" :{" id" :" pc_Z8pzrfSL65" }," $$" :[{" #name" :" text" ," _" :" hazard ratio CI" },{" #name" :" keyword" ," $" :{" id" :" pc_uaJks6bcsT" }," $$" :[{" #name" :" text" ," _" :" confidence interval eGFR" },{" #name" :" keyword" ," $" :{" id" :" pc_Vxaf2fzXNC" }," $$" :[{" #name" :" text" ," _" :" estimated glomerular filtration rate IQR" },{" #name" :" keyword" ," $" :{" id" :" pc_nrzhcGHqkz" }," $$" :[{" #name" :" text" ," _" :" interquartile range ESKD" },{" #name" :" keyword" ," $" :{" id" :" pc_RXhjXoVP2E" }," $$" :[{" #name" :" text" ," _" :" end-stage kidney disease |
本文献已被 ScienceDirect 等数据库收录! |
|