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Abstract

Background: Microvascular complications—diabetic retinopathy, nephropathy, and neuropathy—remain major contributors to morbidity in type 2 diabetes mellitus. Statins, widely used for cardiovascular risk reduction, have been proposed to exert additional microvascular protective effects via pleiotropic mechanisms, though evidence remains inconsistent.
Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines, including randomized controlled trials and observational studies evaluating statin efficacy in preventing microvascular complications. Data on demographics, biochemical parameters, and clinical outcomes were extracted. A random-effects model (RevMan 5.4.1) was used, with outcomes reported as odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI).
Results: Seven clinical trials were included. Statin use showed a statistically significant association with diabetic retinopathy progression (OR: 1.86; 95% CI: 1.72–2.00; P < 0.00001); however, this finding should be interpreted with caution due to substantial heterogeneity (I2 = 97%). Nephropathy events were significantly reduced (OR: 0.75; 95% CI: 0.70–0.80; P < 0.00001; I2 = 0%). Retinopathy incidence also declined (OR: 0.43; 95% CI: 0.33–0.55; P < 0.00001; I2 = 0%). A modest improvement in eGFR was observed (MD: 0.23; 95% CI: 0.22–0.24; P < 0.00001). Qualitative findings suggested reductions in VEGF, bFGF, lipids, and inflammatory markers, though clinical relevance remained uncertain.
Conclusion: Statins may confer protective effects against microvascular complications in type 2 diabetes, particularly retinopathy and nephropathy events. However, heterogeneity and population-specific differences warrant cautious interpretation.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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