慢性肾脏病与眼内压：新加坡马来眼研究。
Chronic kidney disease and intraocular pressure: the Singapore Malay Eye Study.
机构信息
Singapore Eye Research Institute & Singapore National Eye Center, Singapore.
出版信息
Ophthalmology. 2010 Mar;117(3):477-83. doi: 10.1016/j.ophtha.2009.07.029. Epub 2009 Dec 6.
PURPOSE
To examine the relationship of chronic kidney disease (CKD) with intraocular pressure (IOP) and glaucoma in Malay adults in Singapore.
DESIGN
Population-based, cross-sectional study.
PARTICIPANTS
We included 3280 (78.8% response rate) Malay adults aged 40 to 79 years living in Singapore.
METHODS
Participants underwent a standardized interview, ocular examination, imaging, and laboratory investigations. Goldmann applanation tonometry was used to measure IOP. Glaucoma was diagnosed using the International Society of Geographic and Epidemiological Ophthalmology classification. Non-fasting serum glucose, glycosylated hemoglobin, and creatinine were obtained from all participants. Estimated glomerular filtration rate (eGFR) and microalbuminuria were also determined. We defined CKD as eGFR < 60 ml/min/1.73 m(2) or presence of micro/macroalbuminuria, defined as urinary albumin-to-creatinine ratio > or =17 mg/g for men and > or =25 mg/g for women.
MAIN OUTCOME MEASURES
We assessed CKD, IOP, and glaucoma.
RESULTS
The overall prevalence of CKD was 27.92% and glaucoma 4.5%. The mean (standard deviation [SD]) IOP was 15.41 (3.7) mmHg. After adjustments for age and gender, IOP was significantly higher in participants with CKD compared with those without CKD (15.8 vs 15.3 mmHg; P<0.0001). The IOP was also higher with lower levels of eGFR (P<0.001). These associations remained significant in separate stratified analyses of persons with and without diabetes, glaucoma, or both. In multiple linear regression models, persons with CKD had on average IOP that was 0.305 mmHg higher than that of persons without CKD. No association between CKD and glaucoma (age and gender adjusted odds ratio [OR], 0.82; 95% confidence interval [CI], 0.56-1.20; and multivariate adjusted OR, 0.87; 95% CI, 0.58-1.29) was found.
CONCLUSIONS
Our population-based study in Malay adults showed that CKD is associated with higher IOP, independent of age, diabetes, and glaucoma status.
目的
探讨慢性肾脏病（CKD）与新加坡马来成年人眼内压（IOP）和青光眼的关系。
设计
基于人群的横断面研究。
参与者
我们纳入了 3280 名（78.8%的应答率）年龄在 40 至 79 岁之间居住在新加坡的马来成年人。
方法
参与者接受了标准化的访谈、眼部检查、影像学和实验室检查。使用 Goldmann 压平眼压计测量 IOP。使用国际地理和流行病学眼科协会分类法诊断青光眼。所有参与者均进行非空腹血糖、糖化血红蛋白和肌酐检测。还确定了估算肾小球滤过率（eGFR）和微量白蛋白尿。我们将 CKD 定义为 eGFR < 60 ml/min/1.73 m²或存在微量/大量白蛋白尿，定义为男性尿白蛋白与肌酐比值>或=17 mg/g，女性>或=25 mg/g。
主要观察指标
我们评估了 CKD、IOP 和青光眼。
结果
总体 CKD 患病率为 27.92%，青光眼患病率为 4.5%。平均（标准差 [SD]）IOP 为 15.41（3.7）mmHg。调整年龄和性别后，与无 CKD 者相比，CKD 患者的 IOP 显著升高（15.8 对 15.3 mmHg；P<0.0001）。随着 eGFR 水平的降低，IOP 也升高（P<0.001）。在分别对有和无糖尿病、青光眼或两者兼有患者进行分层分析时，这些关联仍然显著。在多元线性回归模型中，CKD 患者的平均 IOP 比无 CKD 患者高 0.305 mmHg。CKD 与青光眼之间无相关性（年龄和性别调整后的比值比 [OR]，0.82；95%置信区间 [CI]，0.56-1.20；和多变量调整后的 OR，0.87；95% CI，0.58-1.29）。
结论
我们在马来成年人中的这项基于人群的研究表明，CKD 与 IOP 升高相关，独立于年龄、糖尿病和青光眼状态。
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