高脂血症、糖尿病与年龄相关性白内障的关系

Association between hyperlipidemia,diabetes and age-related cataract

摘要:

目的：探讨中老年人群高脂血症、糖尿病与年龄相关性白内障(age-related cataract，ARC)的关系。

方法：采用以医院为基础的病例对照研究方法，病例组由年龄45～85岁的360例ARC患者所组成； 对照为与病例同期入住相同医院，未患与ARC有关眼病的360例患者，对照组与病例采取1：1匹配方式。采用自行设计的调查表对研究对象进行调查，内容包括人口学特征、生活方式、疾病既往史等，同时收集研究对象的临床生化检测资料，包括空腹血糖、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)及甘油三酯(TG)等。采用多因素Logistic回归分析，估计研究因素与ARC关联的比值比(OR)及其相应的95%可信区间(CI)。

结果：调整了年龄和性别因素后，高脂血症、高脂血症病程、TC及TG与发生ARC的危险性无关(P>0.05)，仅HDL-C下降与发生ARC的危险性升高有关(OR=1.519，95% CI：1.093～2.110，P=0.013)。在调整了多种潜在性混杂因素后，经多因素Logistic回归分析的结果显示，空腹血糖受损的研究对象发生ARC的危险性升高了73%(OR=1.734，95% CI：1.102～2.725，P<0.001)，而已确诊的糖尿病患者发生ARC的危险性升高了94%(OR=1.938，95% CI：1.293～2.906，P<0.001)。糖尿病病程也与ARC呈显著性正相关，糖尿病病程<10a和10～19a的病例发生ARC的危险性分别是未患糖尿病对照的2倍(OR=2.347，95% CI：1.502～3.752，P=0.010)和3倍(OR=2.683，95% CI：1.267～5.683，P<0.001)。

结论：HDL-C下降及糖尿病可使中老年人群发生ARC的危险性增加。

Abstract:

AIM: To investigate the association between hyperlipidemia and diabetes with the risk of age-related cataract(ARC)in middle-aged and elderly men.

METHODS: A hospital-based case control study was conducted. Cases(n=360)were patients with cataract 45-85 years old. Controls(n=360)were patients with diseases that not related with cataract and were admitted to the same hospital. Cases and controls were matched with 1:1. All subjects were interviewed using a structured interviewer-administrated questionnaire. Questionnaire was designed to cover demographic data, lifestyle, previous diseases history, also collected the clinical biochemical examination data, including fasting blood glucose,high density lipoprotein-cholesterol(HDL-C), total cholesterol(TC), triglyceride(TG). The odds ratios(OR)and corresponding 95% confidence intervals(CI)of ARC were estimated using multiple logistic regression models.

RESULTS: After adjusted for age and gender, hyperlipidemia, hyperlipidemia duration, TC, and TG had no relation with the risk of ARC(P>0.05), though only declining levels of the HDL-C were associated with higher risk of ARC(OR =1.519, 95% CI:1.093-2.110, P=0.013). After adjusting for multiple potential confounders, fasting glucose impaired subjects was positively related with ARC(OR=1.734, 95% CI:1.102-2.725, P<0.001), however, those cases with diabetes had a larger risk than controls(OR=1.938, 95% CI:1.293-2.906, P<0.001)in multivariate logistic regression analysis. Diabetes duration was also positively related with ARC. The risk of ARC less than 10 years and 10 to 19 years in duration significantly increased(OR=2.374; 95%CI: 1.502-3.752, P<0.001 and OR=2.683; 95% CI:1.267-5.683, P=0.010 respectively).

CONCLUSION: This study indicates that the HDL-C, diabetes are associated with an increased risk for ARC in middle-aged and elderly men.