Foster P J, Wong T Y, Machin D, Johnson G J, Seah S K L
Singapore National Eye Centre and Singapore Eye Research Institute, Singapore.
Br J Ophthalmol. 2003 Sep;87(9):1112-20. doi: 10.1136/bjo.87.9.1112.
To describe risk factors for nuclear, cortical, and posterior subcapsular (PSC) cataracts in Chinese Singaporeans.
A population based cross sectional study was carried out on ethnic Chinese men and women aged 40-81 years. A stratified, clustered, disproportionate (more weights to older people), random sampling procedure was used to initially select 2000 Chinese names of those aged 40-79 years from the 1996 electoral register in the Tanjong Pagar district in Singapore. Eligible subjects (n = 1717) were invited for a standardised ocular examination and interview at a centralised clinic, following which an abbreviated examination was conducted for non-respondents in their homes. Cataract was graded clinically using to the Lens Opacity Classification System (LOCS) III system. The main outcome measures were adjusted odds ratio for risk factors for specific cataract types (nuclear, cortical and PSC), any cataract and cataract surgery, examined in multiple logistic regression models.
Out of the 1232 (71.8%) examined, 1206 (70.2%) provided lens data for this analysis. Increasing age was associated with all cataract types, any cataract, and cataract surgery. There was no significant sex difference in presence of any cataract, specific cataract types or cataract surgery. After controlling for age, sex, and other factors, diabetes was associated with cortical cataract (3.1; 95% CI: 1.6 to 6.1), PSC cataract (2.2; 95% CI 1.2 to 4.1), any cataract (2.0; 95% CI: 0.9 to 4.5), and cataract surgery (2.3; 95% CI: 1.3 to 4.1). Lower body mass index was associated with cortical cataract (1.8; 95% CI: 1.1 to 2.9; lowest versus highest quintile) and any cataract (2.3; 95% CI: 1.3 to 4.0). Current cigarette smoking was associated with nuclear cataract (1.7, 95% CI: 1.0 to 2.9; more than 10 cigarettes per day versus none). A non-professional occupation was associated with nuclear cataract (2.9; 95% CI: 1.5 to 5.8; for production or machine operators and 2.6; 95% CI: 1.2 to 5.5; for labourers or agricultural workers, both versus professionals). Lower education was associated with nuclear cataract (2.3; 95% CI: 1.0 to 5.2, none versus tertiary), while lower household income was associated with PSC cataract (4.7, 95% CI: 1.1 to 20.0; income <S$2000 versus >S$4000).
Age related cataracts are associated with a variety of risk factors among Chinese people in Singapore, similar to those reported in European, Indian, and African derived populations. These data support common aetiological mechanisms for age related cataracts, irrespective of ethnic origin.
描述新加坡华裔人群中核性、皮质性和后囊下（PSC）白内障的危险因素。
对40 - 81岁的华裔男性和女性进行了一项基于人群的横断面研究。采用分层、整群、不成比例（老年人权重更大）的随机抽样程序，最初从新加坡丹戎巴葛区1996年选民登记册中选取2000名40 - 79岁华人的姓名。符合条件的受试者（n = 1717）被邀请到一家集中诊所进行标准化眼科检查和访谈，之后对未应答者进行上门简略检查。使用晶状体混浊分类系统（LOCS）III系统对白内障进行临床分级。主要结局指标是在多元逻辑回归模型中检查的特定白内障类型（核性、皮质性和PSC）、任何白内障及白内障手术危险因素的调整比值比。
在接受检查的1232人（71.8%）中，1206人（70.2%）提供了用于本分析的晶状体数据。年龄增长与所有白内障类型、任何白内障及白内障手术均相关。在任何白内障、特定白内障类型或白内障手术的存在方面，无显著性别差异。在控制年龄、性别和其他因素后，糖尿病与皮质性白内障（3.1；95%置信区间：1.6至6.1）、PSC白内障（2.2；95%置信区间1.2至4.1）、任何白内障（2.0；95%置信区间：0.9至4.5）及白内障手术（2.3；95%置信区间：1.3至4.1）相关。较低的体重指数与皮质性白内障（1.8；95%置信区间：1.1至2.9；最低五分位数与最高五分位数相比）及任何白内障（2.3；95%置信区间：1.3至4.0）相关。当前吸烟与核性白内障相关（1.7，95%置信区间：1.0至2.9；每天吸烟超过10支与不吸烟相比）。非专业职业与核性白内障相关（2.9；95%置信区间：1.5至5.8；生产或机器操作员与专业人员相比，以及2.6；95%置信区间：1.2至5.5；体力劳动者或农业工人与专业人员相比）。较低的教育程度与核性白内障相关（2.3；95%置信区间：1.0至5.2，无教育与高等教育相比），而较低的家庭收入与PSC白内障相关（4.7，95%置信区间：1.1至20.0；收入<2000新元与>4000新元相比）。
与年龄相关的白内障在新加坡华裔人群中与多种危险因素相关，类似于在欧洲、印度和非洲裔人群中报告的情况。这些数据支持与年龄相关白内障的共同病因机制，无论种族起源如何。
