与年龄相关性眼病研究（AREDS）中白内障和白内障手术发生相关的危险因素：AREDS 报告 32 号。
Risk factors associated with incident cataracts and cataract surgery in the Age-related Eye Disease Study (AREDS): AREDS report number 32.
机构信息
Neurobiology, Neurodegeneration and Repair Laboratory, National Eye Institute/National Institutes of Health, Bethesda, Maryland, USA.
出版信息
Ophthalmology. 2011 Nov;118(11):2113-9. doi: 10.1016/j.ophtha.2011.03.032.
OBJECTIVE
To investigate potential risk factors associated with incident nuclear, cortical, and posterior subcapsular (PSC) cataracts and cataract surgery in participants in the Age-Related Eye Disease Study (AREDS).
DESIGN
Clinic-based prospective cohort study.
PARTICIPANTS
Persons (n = 4425) 55 to 80 years of age enrolled in a controlled clinical trial of antioxidant vitamins and minerals, AREDS, for age-related macular degeneration and cataract.
METHODS
Lens photographs were graded centrally for nuclear, cortical, and PSC opacities using the AREDS system for classifying cataracts. Type-specific incident cataracts were defined as an increase in cataract grade from none or mild at baseline to a grade of moderate at follow-up, also with a grade of at least moderate at the final visit, or cataract surgery. Cox regression analyses were used to assess baseline risk factors associated with type-specific opacities and cataract surgery.
MAIN OUTCOME MEASURES
Moderate cataract was defined as a grade of 4.0 or more for nuclear opacity, 10% or more involvement within the full visible lens for cortical opacity, and 5% or more involvement of the central 5-mm circle of the lens for PSC opacity. These were graded on baseline and annual lens photographs.
RESULTS
A clinic-based cohort of 4425 persons 55 to 80 years of age at baseline was followed up for an average of 9.8±2.4 years. The following associations were found: increasing age with increased risk of all types of cataract and cataract surgery; males with increased risk of PSC and decreased risk of cortical cataracts; nonwhite persons with increased risk of cortical cataract; hyperopia with decreased risk of PSC, nuclear cataract, and cataract surgery; Centrum (Wyeth Consumer Healthcare, Madison, NJ) use with decreased risk of nuclear cataract; diabetes with increased risk of cortical, PSC cataract, and cataract surgery; higher educational level with decreased risk of cortical cataract; and smoking with increased risk of cortical cataract and cataract surgery. Estrogen replacement therapy in female participants increased the risk of cataract surgery.
CONCLUSIONS
These findings largely are consistent with the results of previous studies, providing further evidence for possible modifiable risk factors for age-related cataract.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
目的
探讨与年龄相关性眼病研究（AREDS）中核性、皮质性和后囊下（PSC）白内障及白内障手术相关的潜在危险因素。
设计
基于临床的前瞻性队列研究。
参与者
年龄在 55 至 80 岁之间的 4425 名参与者参加了一项抗氧化维生素和矿物质的对照临床试验，该试验针对年龄相关性黄斑变性和白内障的 AREDS。
方法
使用 AREDS 系统对晶状体照片进行中央分级，以评估核性、皮质性和 PSC 混浊程度，该系统用于分类白内障。特定类型的新发白内障定义为基线时无或轻度白内障增加至随访时中度白内障，并且在最后一次随访时至少为中度白内障，或行白内障手术。Cox 回归分析用于评估与特定类型混浊和白内障手术相关的基线风险因素。
主要观察指标
中度白内障定义为核性混浊的等级为 4.0 或更高，皮质性混浊的全可见晶状体的 10%或更多受累，PSC 混浊的中央 5mm 圆圈的 5%或更多受累。这些在基线和每年的晶状体照片上进行分级。
结果
在基线时年龄为 55 至 80 岁的基于临床的队列中，4425 名参与者平均随访 9.8±2.4 年。发现以下关联：年龄增加与所有类型白内障和白内障手术风险增加有关；男性 PSC 风险增加，皮质性白内障风险降低；非白人 PSC 性和皮质性白内障风险增加；远视性近视 PSC、核性白内障和白内障手术风险降低；Centrum（Wyeth Consumer Healthcare，Madison，NJ）使用核性白内障风险降低；糖尿病与皮质性、PSC 白内障和白内障手术风险增加有关；教育程度较高与皮质性白内障风险降低有关；吸烟与皮质性白内障和白内障手术风险增加有关。女性参与者中雌激素替代疗法增加了白内障手术的风险。
结论
这些发现与先前研究的结果基本一致，为年龄相关性白内障的可能可改变危险因素提供了进一步的证据。
金融披露
作者没有讨论文章中材料的专有或商业利益。
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