Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 Diabetes

Purpose. This population-based, retrospective cohort study was to investigate whether metformin is associated with a lower risk of subsequent age-related macular degeneration (AMD) in patients with type 2 diabetes. Methods. Using the Taiwan National Health Insurance Research Database from 2001 to 20...

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Main Authors: Yu-Yen Chen, Ying-Cheng Shen, Yun-Ju Lai, Chun-Yuan Wang, Keng-Hung Lin, Shih-Chao Feng, Chiao-Ying Liang, Li-Chen Wei, Pesus Chou
Format: Article
Language:English
Published: Hindawi Limited 2019-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2019/1649156
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spelling doaj-ef8ac307dcc6439aafa1a7c8ef13605a2020-11-24T21:50:07ZengHindawi LimitedJournal of Ophthalmology2090-004X2090-00582019-01-01201910.1155/2019/16491561649156Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 DiabetesYu-Yen Chen0Ying-Cheng Shen1Yun-Ju Lai2Chun-Yuan Wang3Keng-Hung Lin4Shih-Chao Feng5Chiao-Ying Liang6Li-Chen Wei7Pesus Chou8Department of Ophthalmology, Taichung Veterans General Hospital, Taichung 407, TaiwanDepartment of Ophthalmology, Taichung Veterans General Hospital, Taichung 407, TaiwanSchool of Medicine, National Yang-Ming University, Taipei 112, TaiwanDepartment of Ophthalmology, Taichung Veterans General Hospital, Taichung 407, TaiwanDepartment of Ophthalmology, Taichung Veterans General Hospital, Taichung 407, TaiwanDepartment of Ophthalmology, Taichung Veterans General Hospital, Taichung 407, TaiwanDepartment of Ophthalmology, Taichung Veterans General Hospital, Taichung 407, TaiwanDepartment of Ophthalmology, Taichung Veterans General Hospital, Taichung 407, TaiwanSchool of Medicine, National Yang-Ming University, Taipei 112, TaiwanPurpose. This population-based, retrospective cohort study was to investigate whether metformin is associated with a lower risk of subsequent age-related macular degeneration (AMD) in patients with type 2 diabetes. Methods. Using the Taiwan National Health Insurance Research Database from 2001 to 2013, 68205 subjects with type 2 diabetes were enrolled in the study cohort. Among them, 45524 were metformin users and 22681 were nonusers. The metformin and nonmetformin groups were followed until the end of 2013. Cox regression analyses were used to estimate hazard ratios (HRs) for AMD development associated with metformin use. Confounders included for adjustment were age, sex, and comorbidities (hypertension, hyperlipidemia, coronary artery disease, obesity, diabetic retinopathy, chronic kidney disease, and insulin treatment). Furthermore, propensity score (PS) matching method was used to choose the matched sample, and PS-adjusted Cox regression was performed. Finally, how HRs changed according to metformin treatment duration and dose was also evaluated in the metformin group. Results. After adjusting for confounders, the metformin group had a significantly lower risk of AMD (adjusted HR = 0.54; 95% confidence interval [CI], 0.50–0.58). In the PS-matched sample, the significance remained (adjusted HR = 0.57; 95% CI, 0.52–0.63). In the metformin group, the adjusted HRs for the second (1.5–4 years) and third (≥4 years) tertiles of metformin treatment duration were 0.52 and 0.14, respectively, compared with the first tertile (<1.5 years). We also found significant trends of lower HRs (all p-value for trend <0.05) with increasing total and average doses. Conclusions. Among patients with type 2 diabetes, those who use metformin are at a significantly lower risk of developing AMD relative to individuals who do not use metformin. Also, the trend of a significantly lower AMD risk was found with a higher dose of metformin.http://dx.doi.org/10.1155/2019/1649156
collection DOAJ
language English
format Article
sources DOAJ
author Yu-Yen Chen
Ying-Cheng Shen
Yun-Ju Lai
Chun-Yuan Wang
Keng-Hung Lin
Shih-Chao Feng
Chiao-Ying Liang
Li-Chen Wei
Pesus Chou
spellingShingle Yu-Yen Chen
Ying-Cheng Shen
Yun-Ju Lai
Chun-Yuan Wang
Keng-Hung Lin
Shih-Chao Feng
Chiao-Ying Liang
Li-Chen Wei
Pesus Chou
Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 Diabetes
Journal of Ophthalmology
author_facet Yu-Yen Chen
Ying-Cheng Shen
Yun-Ju Lai
Chun-Yuan Wang
Keng-Hung Lin
Shih-Chao Feng
Chiao-Ying Liang
Li-Chen Wei
Pesus Chou
author_sort Yu-Yen Chen
title Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 Diabetes
title_short Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 Diabetes
title_full Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 Diabetes
title_fullStr Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 Diabetes
title_full_unstemmed Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 Diabetes
title_sort association between metformin and a lower risk of age-related macular degeneration in patients with type 2 diabetes
publisher Hindawi Limited
series Journal of Ophthalmology
issn 2090-004X
2090-0058
publishDate 2019-01-01
description Purpose. This population-based, retrospective cohort study was to investigate whether metformin is associated with a lower risk of subsequent age-related macular degeneration (AMD) in patients with type 2 diabetes. Methods. Using the Taiwan National Health Insurance Research Database from 2001 to 2013, 68205 subjects with type 2 diabetes were enrolled in the study cohort. Among them, 45524 were metformin users and 22681 were nonusers. The metformin and nonmetformin groups were followed until the end of 2013. Cox regression analyses were used to estimate hazard ratios (HRs) for AMD development associated with metformin use. Confounders included for adjustment were age, sex, and comorbidities (hypertension, hyperlipidemia, coronary artery disease, obesity, diabetic retinopathy, chronic kidney disease, and insulin treatment). Furthermore, propensity score (PS) matching method was used to choose the matched sample, and PS-adjusted Cox regression was performed. Finally, how HRs changed according to metformin treatment duration and dose was also evaluated in the metformin group. Results. After adjusting for confounders, the metformin group had a significantly lower risk of AMD (adjusted HR = 0.54; 95% confidence interval [CI], 0.50–0.58). In the PS-matched sample, the significance remained (adjusted HR = 0.57; 95% CI, 0.52–0.63). In the metformin group, the adjusted HRs for the second (1.5–4 years) and third (≥4 years) tertiles of metformin treatment duration were 0.52 and 0.14, respectively, compared with the first tertile (<1.5 years). We also found significant trends of lower HRs (all p-value for trend <0.05) with increasing total and average doses. Conclusions. Among patients with type 2 diabetes, those who use metformin are at a significantly lower risk of developing AMD relative to individuals who do not use metformin. Also, the trend of a significantly lower AMD risk was found with a higher dose of metformin.
url http://dx.doi.org/10.1155/2019/1649156
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