Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Ophthalmology. 2010 Mar;117(3):424-30. doi: 10.1016/j.ophtha.2009.07.046. Epub 2010 Jan 4.
To investigate the association between hormone replacement therapy (HRT) and the incidence of cataract extraction among postmenopausal women.
Population-based, prospective cohort study.
A total of 30 861 postmenopausal women participating in the Swedish Mammography Cohort, age 49 to 83 years, who completed a self-administered questionnaire in 1997 about hormone status, HRT, and lifestyle factors.
The women were followed from September 1997 through October 2005. The cohort was matched with registers of cataract extraction in the study area.
Incident operative extraction of age-related cataract.
We identified 4324 incident cases of cataract extractions during 98 months of follow-up. In multivariate adjusted analysis, ever use of HRT was associated with a 14% increased risk of cataract extraction (rate ratio [RR], 1.14; 95% confidence interval [CI], 1.07-1.21) compared with those who never used HRT. Current use of HRT was associated with an 18% increased risk of cataract extraction (RR, 1.18; 95% CI, 1.10-1.26). A significant linear trend was observed where increasing duration of HRT usage resulted in an increased risk of cataract extraction (P for trend = 0.006). Multivariate RR for current HRT usage for >10 years was 1.20 (95% CI, 1.06-1.36; P for trend = 0.001). Among women drinking on average >1 drink of alcohol per day, current HRT users had a 42% increased risk (RR, 1.42; 95% CI, 1.11-1.80) for cataract extraction, compared with women who neither used HRT nor alcohol. The risk of cataract extraction among current users of HRT was similar among current smokers and those who never smoked.
Our prospective, population-based study indicates that postmenopausal women using HRT for a long period of time may be at an increased risk for cataract extraction, especially those drinking >1 alcoholic drink daily.
研究激素替代疗法（HRT）与绝经后妇女白内障摘除发病率之间的关系。
基于人群的前瞻性队列研究。
共 30861 名参加瑞典乳腺 X 线摄影队列的绝经后妇女，年龄 49 至 83 岁，1997 年完成了一份关于激素状况、HRT 和生活方式因素的自我管理问卷。
从 1997 年 9 月到 2005 年 10 月，对这些女性进行随访。该队列与研究区域的白内障摘除登记册相匹配。
年龄相关性白内障的手术性摘除的发病情况。
在 98 个月的随访期间，我们共发现 4324 例白内障摘除病例。在多变量调整分析中，与从未使用 HRT 的女性相比，HRT 的使用与白内障摘除风险增加 14%（率比 [RR]，1.14；95%置信区间 [CI]，1.07-1.21）相关。目前使用 HRT 与白内障摘除风险增加 18%（RR，1.18；95% CI，1.10-1.26）相关。随着 HRT 使用时间的延长，白内障摘除风险呈显著线性增加趋势（趋势检验 P 值=0.006）。当前 HRT 使用>10 年的多变量 RR 为 1.20（95% CI，1.06-1.36；趋势检验 P 值=0.001）。在平均每天饮用>1 份酒精饮料的女性中，与既不使用 HRT 也不饮酒的女性相比，当前 HRT 使用者的白内障摘除风险增加 42%（RR，1.42；95% CI，1.11-1.80）。当前使用 HRT 的女性与从未吸烟的女性相比，其白内障摘除风险相似。
我们的前瞻性、基于人群的研究表明，长期使用 HRT 的绝经后妇女可能面临更高的白内障摘除风险，尤其是那些每天饮用>1 份酒精饮料的妇女。
