Statin therapy and cataract in type 2 diabetes.

Background : It was recently reported that the prolonged use of statins may predispose to incident cataract in the general population. Cataract is a frequent comorbidity of diabetes, and statins are widely prescribed in patients with type 2 diabetes (T2D) both for primary and secondary cardiovascular prevention. For this reason, this study aimed to assess whether or not the use of statins was associated with an increased prevalence of cataract in such a high-risk population and, conversely, whether or not there was greater usage of statins, or any other lipid-lowering drugs, in T2D patients with cataract. Patients and methods : This was a cross-sectional analysis of 780 T2D outpatients, with a mean age (±1 SD) of 64±12 years and diabetes duration of 13±9 years. Diabetic retinopathy (DR) was found in 23%, and cataract was diagnosed in 16.8% (n=131). Age and diabetes duration of the patients with cataract were significantly higher than those of patients without cataract (n=649): 75±9 vs 62±11 years, and 20±11 vs 12±8 years, respectively (both P<0.0001). HbA1c was non-significantly higher in the cataract group: 7.75±1.55% vs 7.57±1.49% (NS). Results : Statins, fibrates and/or ezetimibe use did not differ between patients with and without cataract, nor was cataract prevalence higher in statin users (n=435) vs non-users (n=345). Statin use in patients with cataract was not higher than in cataract-free subgroups with mean age (n=218) or with both mean age and diabetes duration (n=161) similar to those of patients with cataract. Conclusion : In this cross-sectional analysis of a large diabetic population at very high risk of both DR and cataract, chronic therapy with statins was not cataractogenic, and the presence of cataract was not associated with more statin or other lipid-lowering drug use. This suggests that the benefits of statin therapy in T2D may far outweigh any potential ocular drawbacks as a side effect which, in any case, were not supported by our findings.