Leung W-C, Harvey I
Medicine, Health Policy and Practice, Elizabeth Fry Building, University of East Anglia, Norwich NR4 7TJ, U.K.
Br J Dermatol. 2002 Dec;147(6):1187-91. doi: 10.1046/j.1365-2133.2002.04991.x.
There is little clear evidence of a strong association between cumulative sun exposure and skin wrinkling. Contradictory findings also exist on the association between facial wrinkling and smoking status.
To identify the significant determinants of skin wrinkling in a cohort of older subjects and to assess whether skin wrinkling can be used as an objective measure of cumulative sun exposure.
This study was carried out in the South Glamorgan health district, Wales, U.K., between 1988 and 1991. A random sample of 792 older subjects (60 years and over) was obtained from the Health Authority register of patients registered with general practitioners. A range of phenotypic and environmental data was collected during a home visit by interview and examination by an experienced dermatology research fellow. Skin wrinkling/ageing was assessed by examining the face, neck and dorsum of the hand and scored on a 10-point ordinal scale. Cumulative sun exposure was assessed by asking subjects to estimate their average outdoor time during each of three periods of adult life. This measure showed acceptable repeatability (r = 0.64 for estimates obtained 1.4 years apart).
The response rate was 71% and the mean age of participants was 71 years. The mean +/- SD skin ageing score was 5.5 +/- 1.5. In multiple logistic regression models only age and daily cigarette consumption were significantly associated with skin ageing. Cumulative sun exposure was significant on univariable analysis but this effect was removed by adjusting for age. Smoking 20 cigarettes per day was equivalent in effect to almost 10 years of chronological ageing.
Smoking is an important determinant of macroscopic skin ageing/wrinkling in older subjects. This evidence suggests that skin ageing does not clearly provide an objective measure of cumulative ultraviolet exposure, and caution should be exercised before it is used in this way. The association between smoking and wrinkling provides important information for potential use in education campaigns to reduce smoking prevalence among young people.
几乎没有明确证据表明累积日照与皮肤皱纹之间存在强关联。关于面部皱纹与吸烟状况之间的关联也存在相互矛盾的研究结果。
确定一组老年受试者皮肤皱纹的重要决定因素，并评估皮肤皱纹是否可作为累积日照的客观指标。
本研究于1988年至1991年在英国威尔士南格拉摩根健康区开展。从卫生当局注册的全科医生患者登记册中随机抽取了792名老年受试者（60岁及以上）。在一次家访期间，由经验丰富的皮肤科研究员通过访谈和检查收集了一系列表型和环境数据。通过检查面部、颈部和手背评估皮肤皱纹/老化情况，并按10分序数量表评分。通过要求受试者估计成年生活三个阶段中每个阶段的平均户外时间来评估累积日照。该测量方法显示出可接受的重复性（间隔1.4年获得的估计值的r = 0.64）。
应答率为71%，参与者的平均年龄为71岁。皮肤老化评分的均值±标准差为5.5±1.5。在多因素逻辑回归模型中，只有年龄和每日吸烟量与皮肤老化显著相关。累积日照在单因素分析中具有显著性，但在调整年龄后该效应消失。每天吸20支烟的影响几乎等同于按实际年龄计算的近10年老化。
吸烟是老年受试者宏观皮肤老化/皱纹的重要决定因素。该证据表明，皮肤老化并不能明确作为累积紫外线暴露的客观指标，在以这种方式使用之前应谨慎。吸烟与皱纹之间的关联为在教育活动中潜在用于降低年轻人吸烟率提供了重要信息。
