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医师健康研究I中的基线自我报告白内障与后续死亡率

Baseline self-reported cataract and subsequent mortality in Physicians' Health Study I.

作者信息

Christen W G, Glynn R J, Ajani U A, Schaumberg D A, Manson J E, Buring J E, Hennekens C H

机构信息

Division of Preventive Medicine, Harvard Medical School and Brigham & Women's Hospital, Boston, MA, USA.

出版信息

Ophthalmic Epidemiol. 2000 Jun;7(2):115-25.

Abstract

PURPOSE

To examine whether a reported history of cataract, a possible marker of aging, is associated with future mortality.

METHODS

Participants were 18,669 of the 22,071 U.S. male physicians enrolled in the Physicians' Health Study I who had complete information at study entry, including self-report of presence or absence of baseline cataract. Participants were without a previous history of myocardial infarction, stroke, transient cerebral ischemia, or cancer (except non-melanoma skin cancer). Reported deaths were confirmed by an End Points Committee of physicians.

RESULTS

A total of 581 participants reported a personal history of cataract at baseline. During an average of 12.4 years of follow-up, there were 1,514 deaths including 496 due to cardiovascular (CV) and 1,018 due to non-CV causes. After adjustment for differences in age, men who reported cataract at baseline had a non-significant 9% increased risk of death from any cause compared to men who did not report cataract (RR, 1.09; 95% CI, 0.91-1.30). The RRs were 1.03 (95% CI, 0.75-1.41) for CV death and 1.12 (95% CI, 0.90-1.40) for non-CV death. Adjustment for other risk factors had little effect on these estimates. Similar results were obtained in analyses conducted separately among those with and without self-reported diabetes at baseline.

CONCLUSIONS

These results from a population of generally healthy physicians indicate that a report of a history of cataract is not associated with any material increase in mortality after adjustment for differences in age between men with and without cataract. Additional investigation of this cohort is in progress to determine whether incident age-related cataracts as well as their subtypes, confirmed by medical record review, are associated with increased mortality.

摘要

目的

探讨报告的白内障病史(一种可能的衰老标志物)是否与未来死亡率相关。

方法

参与者为参加医师健康研究I的22071名美国男性医师中的18669名,他们在研究开始时拥有完整信息,包括基线白内障存在与否的自我报告。参与者无心肌梗死、中风、短暂性脑缺血或癌症病史(非黑色素瘤皮肤癌除外)。报告的死亡情况由医师终点委员会确认。

结果

共有581名参与者在基线时报告有白内障个人史。在平均12.4年的随访期间,有1514人死亡,其中496人死于心血管疾病(CV),1018人死于非CV原因。在调整年龄差异后,与未报告白内障的男性相比,基线时报告有白内障的男性全因死亡风险增加9%,但差异无统计学意义(RR,1.09;95%CI,0.91 - 1.30)。CV死亡的RR为1.03(95%CI,0.75 - 1.41),非CV死亡的RR为1.12(95%CI,0.90 - 1.40)。调整其他风险因素对这些估计值影响不大。在基线时自我报告有糖尿病和无糖尿病的人群中分别进行的分析也得到了类似结果。

结论

这些来自总体健康医师人群的结果表明,在调整有白内障和无白内障男性之间的年龄差异后,白内障病史报告与死亡率的任何实质性增加均无关联。正在对该队列进行进一步调查,以确定经病历审查确认的新发年龄相关性白内障及其亚型是否与死亡率增加相关。

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