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引用:李金金,李莫东,李杰,杨肖,夏丹,李雨,王伟,严非,张建.高血压合并糖尿病与白内障的相关性.国际眼科杂志 2020;20(10):1673-1679,doi:10.3980/j.issn.1672-5123.2020.10.02
高血压合并糖尿病与白内障的相关性
Hypertension and diabetes synergistically strengthen the association with cataracts
投稿时间:2019-07-11  修订日期:2020-07-19
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DOI:10.3980/j.issn.1672-5123.2020.10.02
关键词:  病例对照  白内障  合并型  糖尿病  高血压
Key Words:  case-control  cataract  comorbidity  diabetes  hypertension
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作者单位
李金金 中国安徽省阜阳市人民医院眼科
李莫东 中国安徽省阜阳市人民医院眼科
李杰 中国安徽省阜阳市人民医院眼科
杨肖 中国安徽省阜阳市人民医院眼科
夏丹 中国安徽省阜阳市人民医院眼科
李雨 中国安徽省阜阳市人民医院眼科
王伟 中国上海市复旦大学公共卫生学院社会医学系
严非 中国上海市复旦大学公共卫生学院社会医学系
张建 30460美国南佐治亚州大学徐建平公共卫生学院流行病学系
                          
AuthorInstitution
Jin-Jin Li Department of Ophthalmology, People's Hospital of Fuyang City, Fuyang , Anhui Province, China
Mo-Dong Li Department of Ophthalmology, People's Hospital of Fuyang City, Fuyang , Anhui Province, China
Jie Li Department of Ophthalmology, People's Hospital of Fuyang City, Fuyang , Anhui Province, China
Xiao Yang Department of Ophthalmology, People's Hospital of Fuyang City, Fuyang , Anhui Province, China
Dan Xia Department of Ophthalmology, People's Hospital of Fuyang City, Fuyang , Anhui Province, China
Yu Li Department of Ophthalmology, People's Hospital of Fuyang City, Fuyang , Anhui Province, China
Wei Wang Department of Social Medicine, School of Public Health, Fudan University, Shanghai , China
Fei Yan Department of Social Medicine, School of Public Health, Fudan University, Shanghai , China
Jian Zhang Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro 30460, GA, USA
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目的:探讨年龄相关性白内障(ARC)与合并型高血压、糖尿病的关系。

     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)。

     结论:非合并型高血压或糖尿病与ARC轻微或中度相关。合并型高血压和糖尿病与ARC则高度相关。合并有高血压和糖尿病的患者应为白内障防治的重点人群。

Abstract:
      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.

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