方法：排除创伤、先天性异常，相关药物或白内障手术史，年龄相关性白内障定义为至少一只眼睛存在有晶状体混浊。从我科2011-01-01/2017-05-20收治的6 467例50岁及以上眼科患者中，4 316例出院确诊为白内障， 其中的3 343为ARC。同一时期入住我科的379例50岁及以上眼外伤患者，检查确认无白内障的临床证据者作为年龄匹配对照组纳入分析。我们使用非条件Logistic回归模型估计似然比(OR)，同时获取年龄、性别、城乡差别和医疗保健的可及性。
结果：男性白内障患者中， 29.54%(n=1 275)同时患有高血压； ARC男性患者，30.12%(n=1 007)同时患有高血压。眼外伤患者中只有10.82%(n=41)患者合并高血压。研究合并糖尿病患病率：男性白内障患者中，16.64%(n=718)同时患有糖尿病； ARC男性患者中， 16.48%(n=551)同时患有糖尿病， 而同龄的眼外伤患者中只有4.22%(n=16)，在女性患者中观察到类似的模式。多因素分析表明高血压与ARC的相关性相对微弱 \〖OR=1.83(95% CI=1.23，2.74)\〗，糖尿病与ARC的相关性较强\〖OR=3.38(95% CI=1.86，6.15)\〗，但合并型高血压和糖尿病与ARC有着极强的相关性，OR=18.20(4.38，75.59)。
AIM: To examine the relationship between age-related cataracts(ARC)and comorbid hypertension and diabetes.
METHODS: We analyzed the administrative records of 6 467 patients aged 50 years and older admitted to the ophthalmological department of a tertiary hospital from January 1st, 2011 to May 20th, 2017. With either eye considered, an ARC(n=3 343)was defined as the presence of lens opacity or previous cataract surgery without evidence of trauma, congenital anomalies or using certain medications. Patients admitted to the same department during the same period due to ocular traumas without clinical evidence of cataracts(n=379)were recruited as the cataract-free controls. Unconditional Logistic regressions were ran to obtain the odds ratio(OR)of hypertension and diabetes among ARC patients adjusted for age, sex and health care accessibility.
RESULTS: Hypertension was diagnosed in 29.54% of men with any type of cataracts, in 30.12% of men with an ARC, and 10.82% of men of cataract-free controls. Diabetes was diagnosed in 16.64% of men with any type of cataracts, in 16.48% of men with ARC and 4.22% of men of cataract-free controls. Similar patterns were observed among women. After adjusting for age, sex, and health care accessibility, hypertension was weakly \〖OR=1.83(95% CI: 1.23, 2.74)\〗 and diabetes was strongly \〖3.38(1.86, 6.15)\〗 associated with ARCs. The adjusted OR of comorbid hypertension and diabetes among adults with ARC was 18.20(4.38, 75.59).
CONCLUSION: Hypertension and diabetes were independently associated with ARC. Hypertension and diabetes, if co-existing, multiplicatively strengthened the association with ARC.