Impact of SGLT2 inhibitors on the risk of age-related ocular diseases in patients with type 2 diabetes mellitus: A target trial emulation study.

IF 5.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism Pub Date : 2025-09-11 DOI:10.1111/dom.70131

Yueh-Tsung Lee, Jheng-Yan Wu, Tsung W Chang, Cheng-Hsien Hung

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引用次数: 0

Abstract

Aims: Chronic ocular diseases such as age-related macular degeneration (AMD) are leading causes of vision loss in older adults. While sodium-glucose co-transporter 2 inhibitors (SGLT2i) are widely prescribed in the management of type 2 diabetes mellitus (T2DM), their effects on ocular disease risk remain largely unknown.

Materials and methods: This retrospective cohort study evaluated the association between SGLT2i use and the risk of AMD and other age-related ocular conditions in adults aged ≥60 with T2DM, using a target trial emulation framework based on the TriNetX global health research network (2013-2025). Patients initiating SGLT2i or dipeptidyl peptidase-4 inhibitors (DPP4i) were propensity-matched 1:1. Primary outcomes were incident non-exudative, exudative, and atrophic AMD, and secondary outcomes included cataract, ocular hypertension, and primary open-angle glaucoma.

Results: In 12 156 matched patients, SGLT2i use was associated with significantly lower risks of non-exudative AMD (HR 0.64; 95% CI 0.49-0.84) and exudative AMD (HR 0.56; 95% CI 0.33-0.96) compared with DPP4i use. A slight increase in the risk of cataract was observed (HR 1.08; 95% CI 1.02-1.15), while no significant differences were found for atrophic AMD, ocular hypertension, or glaucoma.

Conclusions: These findings suggest that SGLT2i may offer retinal protective effects in older adults with T2DM, supporting further mechanistic and prospective clinical studies.

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SGLT2抑制剂对2型糖尿病患者年龄相关性眼部疾病风险的影响：一项目标试验模拟研究

目的：慢性眼部疾病，如年龄相关性黄斑变性（AMD）是老年人视力丧失的主要原因。虽然钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）被广泛用于2型糖尿病（T2DM）的治疗，但它们对眼部疾病风险的影响在很大程度上仍然未知。材料和方法：本回顾性队列研究使用基于TriNetX全球健康研究网络（2013-2025）的目标试验模拟框架，评估SGLT2i使用与≥60岁T2DM患者AMD和其他年龄相关眼部疾病风险之间的关系。开始使用SGLT2i或二肽基肽酶-4抑制剂（DPP4i）的患者倾向匹配为1:1。主要结局是偶发的非渗出性、渗出性和萎缩性AMD，次要结局包括白内障、高眼压和原发性开角型青光眼。结果：在12156例匹配的患者中，与使用DPP4i相比，SGLT2i的使用显著降低了非渗出性AMD （HR 0.64; 95% CI 0.49-0.84）和渗出性AMD （HR 0.56; 95% CI 0.33-0.96）的风险。观察到白内障的风险略有增加（HR 1.08; 95% CI 1.02-1.15），而萎缩性黄斑变性、高眼压或青光眼的风险无显著差异。结论：这些发现表明SGLT2i可能对老年T2DM患者具有视网膜保护作用，支持进一步的机制和前瞻性临床研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.