Dasch Burkhard, Fuhs Andrea, Behrens Thomas, Meister Astrid, Wellmann Juergen, Fobker Manfred, Pauleikhoff Daniel, Hense Hans-Werner
Institute of Epidemiology and Social Medicine, University of Muenster, Germany.
Arch Ophthalmol. 2005 Nov;123(11):1501-6. doi: 10.1001/archopht.123.11.1501.
To evaluate recent reports indicating that plasma levels of fibrinogen and high-sensitivity C-reactive protein (CRP) are associated with age-related maculopathy (ARM).
From the baseline examinations of the Muenster Aging and Retina Study, a cohort of 1060 subjects aged 59 to 82 years was assembled. Of these, 873 persons (82%) with bilateral gradable fundus photographs and complete data on fibrinogen, CRP, and potential confounders were included in a cross-sectional analysis. The main outcome measure was the association among fibrinogen, CRP, and ARM as assessed by multivariate logistic regression analysis.
Fibrinogen and CRP levels were higher among participants with early and late ARM than among those without ARM. The crude odds ratios for ARM between the highest vs the lowest quartile were 1.90 (95% confidence interval [CI], 1.29-2.80) for fibrinogen and 1.43 (95% CI, 0.97-2.10) for CRP. After adjustment for cardiovascular risk factors, these odds ratios were 1.37 for fibrinogen (95% CI, 0.91-2.06) and 1.12 (95% CI, 0.73-1.73) for CRP.
After adjustment for cardiovascular risk factors, we found no statistically significant association between fibrogen, CRP, and ARM. Therefore, our results do not indicate a role of systemic inflammation in ARM beyond what is already present owing to concurrent cardiovascular disease.
评估近期报告,这些报告表明纤维蛋白原和高敏C反应蛋白(CRP)的血浆水平与年龄相关性黄斑病变(ARM)有关。
从明斯特衰老与视网膜研究的基线检查中,选取了1060名年龄在59至82岁之间的受试者组成队列。其中,873人(82%)有可分级的双侧眼底照片,且有关于纤维蛋白原、CRP和潜在混杂因素的完整数据,被纳入横断面分析。主要结局指标是通过多因素逻辑回归分析评估纤维蛋白原、CRP与ARM之间的关联。
早期和晚期ARM参与者的纤维蛋白原和CRP水平高于无ARM者。纤维蛋白原最高四分位数与最低四分位数相比,ARM的粗比值比为1.90(95%置信区间[CI],1.29 - 2.80),CRP为1.43(95%CI,0.97 - 2.10)。在调整心血管危险因素后,纤维蛋白原的比值比为1.37(95%CI,0.91 - 2.06),CRP为1.12(95%CI,0.73 - 1.73)。
在调整心血管危险因素后,我们发现纤维蛋白原、CRP与ARM之间无统计学显著关联。因此,我们的结果并未表明全身炎症在ARM中的作用超出了因并发心血管疾病而已经存在的作用。