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Submitted: 04 Apr 2024
Accepted: 15 Jun 2024
ePublished: 29 Jun 2024
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J Nephropharmacol. 2024;13(2): e12688.
doi: 10.34172/npj.2024.12688
  Abstract View: 128
  PDF Download: 98

Meta Analysis

The association between the utilization of SGLT2 inhibitors and diabetic retinopathy; a systematic review and meta-analysis of cohort studies

Shahriar Barkhordari 1 ORCID logo, Shahrzad Ghaffariyan 2,3 ORCID logo, Farzin Banei 4 ORCID logo, Mohammad Shirvani 5 ORCID logo, Farangis yazdanjou 1 ORCID logo, Sara Ghaseminejad Kermani 6 ORCID logo, Mohammad Akbari 7 ORCID logo, Alireza Baghaei 8 ORCID logo, Mobin Mohammadtabar 9* ORCID logo

1 Department of Ophthalmology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 General Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Guissu Research Corporation, Bandar Abbas, Iran
4 Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Shiraz Transplant Center, Abu-Ali Sina Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
6 Department of Emergency Medicine, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7 Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
8 Dentistry School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
9 Department of Ophthalmology, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
*Corresponding Author: Mobin Mohammadtabar, Email: Mobin.mhbr@gmail.com

Abstract

Introduction: Diabetic retinopathy is one of the principal causes of blindness globally. The impact of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, a category of anti-diabetic medications, on diabetic retinopathy remains undetermined. Consequently, this study aimed to examine the association between the utilization of SGLT2 inhibitors and the incidence of diabetic retinopathy.

Materials and Methods: This investigation systematically searched databases, including Web of Science, Cochrane, ProQuest, PubMed, and Google Scholar, until March 7, 2024. A systematic review and meta-analysis methodology was employed. Data were analyzed using STATA software version 14, considering a significance level of tests at P<0.05.

Results: The application of SGLT2 inhibitors was connected with a diminished diabetic retinopathy risk (odds ratio [OR]: 0.77, 95% CI: 0.69, 0.86). Among women, SGLT2 inhibitor use did not notably influence diabetic retinopathy risk (OR: 0.84, 95% CI: 0.69, 1.03). However, among men, employing SGLT2 inhibitors decreased the risk (OR: 0.81, 95% CI: 0.71, 0.92). In comparison to dipeptidyl peptidase-4 inhibitors (OR: 0.70, 95% CI: 0.53, 0.94) and pioglitazone (OR: 0.75, 95% CI: 0.74, 0.76), SGLT2 inhibitors lowered the risk of diabetic retinopathy. However, when compared to sulfonylureas (OR: 0.45, 95% CI: 0.17, 1.17) and GLP1-RA (OR: 0.70, 95% CI: 0.42, 1.17), SGLT2 inhibitors did not notably affect diabetic retinopathy. Moreover, using SGLT2 inhibitors in the age groups of 50-54 years (OR: 0.74, 95% CI: 0.55, 0.98), 55-59 years (OR: 0.65, 95% CI: 0.53, 0.79), and 60-64 years (OR: 0.89, 95% CI: 0.82, 0.97) was linked to lower diabetic retinopathy risk. Nevertheless, in the 65-69 age group, SGLT2 inhibitor administration did not significantly alter the diabetic retinopathy risk (OR: 1.04, 95% CI: 0.94, 1.15).

Conclusion: The intake of SGLT2 inhibitors has been linked to a diminution in the hazard of diabetic retinopathy. However, further research in this domain is recommended, given the need for studies examined.

Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (CRD42024523959) and Research Registry (UIN: reviewregistry1808) website.


Implication for health policy/practice/research/medical education:

This meta-analysis highlights the potential benefits of SGLT2 inhibitors in reducing the risk of diabetic retinopathy, particularly in men under the age of 65 years old. Therefore, health policies should consider promoting the use of SGLT2 inhibitors as a first-line treatment option for male diabetic patients in this age group, especially when compared to other medications such as pioglitazone and dipeptidyl peptidase-4 inhibitors.

Please cite this paper as: Barkhordari S, Ghaffariyan S, Banei F, Shirvani M, Yazdanjou F, Ghaseminejad Kermani S, Akbari M, Baghaei A, Mohammadtabar M. The association between the utilization of SGLT2 inhibitors and diabetic retinopathy; a systematic review and meta-analysis of cohort studies. J Nephropharmacol. 2024;13(2):e12688. DOI: 10.34172/npj.2024.12688.

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