Buch Helena, Vinding Troels, la Cour Morten, Jensen Gorm B, Prause Jan U, Nielsen Niels V
Department of Ophthalmology, Rigshospitalet, National University Hospital, Copenhagen, Denmark.
Acta Ophthalmol Scand. 2005 Aug;83(4):409-18. doi: 10.1111/j.1600-0420.2005.00492.x.
To examine the association between potential risk factors and the 14-year incidence of age-related maculopathy (ARM).
Population-based cohort study.
At baseline, 946 volunteers participated in the study during 1986--88. These subjects were between 60 and 80 years of age and lived in the Østerbro district of Copenhagen. Excluding participants who had died since baseline, 359 subjects (97.3% of survivors) were re-examined 14 years later, during 2000--2002. A total of 31.8% (301/946) of the original material was included in the risk factor analyses.
Participants underwent an ophthalmological examination at Rigshospitalet, the National University Hospital of Copenhagen. Similar standardized protocols for physical examination were used at the baseline and follow-up examinations. Age-related maculopathy lesions were determined by the same grader grading colour fundus photographs from both examinations using a modification of the Wisconsin Age-related Maculopathy Grading System protocol.
Of the 359 participants, 94 had incident early ARM and 52 had incident late ARM at follow-up in either eye. In logistic regression, the risk factors for early ARM or worse were as follows: cataract (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.2-6.2); family history of ARM (OR 4.5, 95% CI 1.3--15.5), and alcohol consumption >250 g/week (OR 4.6, 95% CI 1.1-19.2). High levels of apolipoprotein B (>100 mg/l) decreased the risk of development of early ARM or worse (OR 0.4, 95% CI 0.2-0.8), while high levels of apolipoprotein A1 (>or= 150 mg/l) increased the risk of late ARM (OR 2.5, 95% CI 1.2-5.3). Advanced age at baseline was also associated with the incidence of late ARM (OR 2.0, 95% CI 1.4-2.9).
These findings indicate a direct correlation between age, cataract, family history, alcohol consumption, the apolipoproteins A1 and B and the 14-year incidence of ARM.
研究潜在风险因素与年龄相关性黄斑病变（ARM）14年发病率之间的关联。
基于人群的队列研究。
在基线期，946名志愿者于1986 - 1988年参与了该研究。这些受试者年龄在60至80岁之间，居住在哥本哈根的Østerbro区。排除自基线期后死亡的参与者，14年后，即在2000 - 2002年，对359名受试者（占幸存者的97.3%）进行了重新检查。共有31.8%（301/946）的原始资料纳入了风险因素分析。
参与者在哥本哈根国立大学医院Rigshospitalet接受了眼科检查。在基线期和随访检查中使用了相似的标准化体格检查方案。年龄相关性黄斑病变损害由同一名分级者根据改良的威斯康星年龄相关性黄斑病变分级系统方案，对两次检查的彩色眼底照片进行分级来确定。
在359名参与者中，随访时94人一只眼或双眼发生早期ARM，52人发生晚期ARM。在逻辑回归分析中，早期ARM或更严重病变的风险因素如下：白内障（比值比[OR] 2.8，95%置信区间[CI] 1.2 - 6.2）；ARM家族史（OR 4.5，95% CI 1.3 - 15.5），以及每周饮酒量>250克（OR 4.6，95% CI 1.1 - 19.2）。载脂蛋白B水平高（>100毫克/升）降低了发生早期ARM或更严重病变的风险（OR 0.4，95% CI 0.2 - 0.8），而载脂蛋白A1水平高（≥150毫克/升）增加了晚期ARM的风险（OR 2.5，95% CI 1.2 - 5.3）。基线期年龄较大也与晚期ARM的发病率相关（OR 2.0，95% CI 1.4 - 2.9）。
这些发现表明年龄、白内障、家族史、饮酒量、载脂蛋白A1和B与ARM的14年发病率之间存在直接关联。
