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Role of lipid-lowering agents in the management of diabetic retinopathy

World Journal of Diabetes 2017年第1期8卷 1-6页

作者： Estelle Ioannidou Vasilis-Spyridon Tseriotis Konstantinos Tziomalos First Propedeutic Department of Internal Medicine Medical SchoolAristotle University of ThessalonikiAHEPA Hospital54636 ThessalonikiGreece

Diabetic retinopathy affects a substantial proportion of patients with diabetes mellitus(DM) and is the leading cause of blindness in working-aged adults. Even though the incidence of diabetic retinopathy has declined in the last decades, its prevalence increased and is expected to rise further as a result of the increasing incidence of type 2 DM(T2DM) and the longer life expectancy of patients with DM. The pathogenesis of diabetic retinopathy is multifactorial. Some observational studies suggested an association between dyslipidemia and the development and progression of retinopathy in patients with DM but others did not confirm this association. Regarding lipid-lowering agents, studies that evaluated the role of statins in the management of these patients are mostly small and yielded discrepant results. Large randomized studies with statins in patients with T2DM showed no benefit of these agents on diabetic retinopathy but were not designed to address this effect. In contrast, both preclinical data and two large randomized controlled studies, the FIELD and the ACCORD trial, showed that fenofibrate delays the progression of diabetic retinopathy. Even though the mechanisms underpinning this favorable effect are not entirely clear, these findings suggest that fenofibrate might represent a useful tool for the management of diabetic retinopathy.

关键词： Diabetes mellitus lipid-lowering agents Statins Fibrates Ezetimibe Colesevelam Retinopathy

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