Meddings D R, Marion S A, Barer M L, Evans R G, Green B, Hertzman C, Kazanjian A, McGrail K M, Sheps S B
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada.
Epidemiology. 1999 May;10(3):288-93.
Senile cataract may be a marker of generalized tissue aging. We examined this hypothesis using population-based linked health data. We hypothesized that any such association would diminish with increased use of cataract surgery. Mortality rates of those 50-95 years of age undergoing cataract surgery in British Columbia during either 1985 or 1989 were compared with the provincial population of comparable age who did not undergo cataract surgery during the study period. The 1985 cohort included 8,262 patients undergoing surgery and a comparison population of 804,303, and the 1989 cohort included 11,952 patients and a comparison population of 839,393. Using Cox regression, for the 1985 cohort, the hazard ratios for dying during follow-up were 3.2 for males 50-54.9 years of age [95% confidence limits (CL) = 2.0, 5.0] and 3.3 for females (95% CL = 1.9, 5.7). Hazard ratios for older age groups decreased with age. We also fit an additive risk model that produced excess mortalities that were less age dependent. In the 1985 analysis, these ranged from +7.1 per 1,000 (95% CL = +0.44, +13.76) to +20.3 (95% CL = +13.24, +27.36) for males and -17.5 (95% CL = -28.28, -6.72) to +2.0 (95% CL = -2.12, +6.12) for females. Findings for the 1989 analyses were similar, indicating that the association between cataracts and generalized aging remained constant despite a large increase in the use of cataract surgery.
老年性白内障可能是全身组织衰老的一个标志。我们使用基于人群的关联健康数据对这一假设进行了研究。我们假设,随着白内障手术使用率的增加,任何此类关联都会减弱。将1985年或1989年在不列颠哥伦比亚省接受白内障手术的50至95岁人群的死亡率与在研究期间未接受白内障手术的同龄省级人群进行了比较。1985年的队列包括8262名接受手术的患者和804303名对照人群,1989年的队列包括11952名患者和839393名对照人群。使用Cox回归分析,对于1985年的队列,50至54.9岁男性在随访期间死亡的风险比为3.2[95%置信区间(CL)=2.0,5.0],女性为3.3(95%CL=1.9,5.7)。老年组的风险比随年龄降低。我们还拟合了一个相加风险模型,该模型产生的额外死亡率对年龄的依赖性较小。在1985年的分析中,男性的这些值范围为每1000人+7.1(95%CL=+0.44,+13.76)至+20.3(95%CL=+13.24,+27.36),女性为-17.5(95%CL=-28.28,-6.72)至+2.0(95%CL=-2.12,+6.12)。1989年分析的结果相似,表明尽管白内障手术的使用率大幅增加,但白内障与全身衰老之间的关联仍然存在。