美国两项前瞻性队列研究中剥脱性青光眼的人口统计学和地理特征。
Demographic and geographic features of exfoliation glaucoma in 2 United States-based prospective cohorts.
机构信息
Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham & Women's Hospital, Boston, Massachusetts, USA.
出版信息
Ophthalmology. 2012 Jan;119(1):27-35. doi: 10.1016/j.ophtha.2011.06.018. Epub 2011 Oct 7.
PURPOSE
To examine prospectively the association between demographic and geographic factors in relation to exfoliation glaucoma (EG) or exfoliation glaucoma suspect (EGS).
DESIGN
Prospective cohort study.
PARTICIPANTS
Seventy-eight thousand nine hundred fifty-five women in the Nurses' Health Study and 41 191 men in the Health Professionals Follow-up Study.
METHODS
Female and male health professionals were followed prospectively from 1980 through 2008 and from 1986 through 2008, respectively. Eligible participants were 40 years of age or older, did not have EG or EGS at baseline, and reported undergoing eye examinations during follow-up. Information regarding demographic features, lifetime geographic residence, and potential confounders was collected. During follow-up, 348 EG or EGS cases were confirmed with medical record review. The relative risk of EG or EGS in each cohort was estimated separately and the results were pooled with meta-analysis.
MAIN OUTCOME MEASURES
Multivariate rate ratios (MVRRs) of EG or EGS and their 95% confidence intervals (CIs).
RESULTS
Exfoliation glaucoma or EGS was strongly age related with subjects 75 years of age or older at 46.22-fold (95% CI, 22.77-93.80) increased risk compared with those between 40 and 55 years of age. Although men were 68% less likely to develop EG or EGS than women (MVRR, 0.32; 95% CI, 0.23-0.46), no predisposition to EG or EGS by ancestry, particularly Scandinavian ancestry, emerged. Compared with a lifetime of living in the northern tier of the continental United States, lifetime residence in the middle geographic tier (MVRR, 0.53; 95% CI, 0.40-0.71) and in the southern geographic tier (MVRR, 0.25; 95% CI, 0.09-0.71) was associated with markedly reduced risks of EG or EGS.
CONCLUSIONS
In this mainly white cohort from the United States, increasing age and female gender were significant risk factors for EG or EGS; however, Scandinavian heritage was not. Living in the middle or southern regions of the United States relative to living in the northern region was associated with a reduced risk of EG or EGS.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
目的
前瞻性研究与剥脱性青光眼（EG）或剥脱性青光眼疑似（EGS）相关的人口统计学和地理因素。
设计
前瞻性队列研究。
参与者
护士健康研究中的 78955 名女性和健康专业人员随访研究中的 41191 名男性。
方法
从 1980 年到 2008 年，女性健康专业人员进行了前瞻性随访，从 1986 年到 2008 年，男性健康专业人员进行了前瞻性随访。符合条件的参与者年龄在 40 岁或以上，基线时没有 EG 或 EGS，并且报告在随访期间接受了眼部检查。收集了有关人口统计学特征、终身地理居住地和潜在混杂因素的信息。在随访期间，通过病历回顾确认了 348 例 EG 或 EGS 病例。分别估计了每个队列中 EG 或 EGS 的相对风险比（MVRR），并通过荟萃分析对结果进行了汇总。
主要观察指标
EG 或 EGS 的多变量率比（MVRR）及其 95%置信区间（CI）。
结果
剥脱性青光眼或 EGS 与年龄密切相关，年龄在 75 岁或以上的患者的风险是 40 至 55 岁之间的患者的 46.22 倍（95%CI，22.77-93.80）。尽管男性患 EG 或 EGS 的可能性比女性低 68%（MVRR，0.32；95%CI，0.23-0.46），但他们没有出现 EG 或 EGS 的遗传倾向，特别是斯堪的纳维亚血统。与终生居住在美国北部地区相比，终生居住在美国中部地区（MVRR，0.53；95%CI，0.40-0.71）和南部地区（MVRR，0.25；95%CI，0.09-0.71）与 EG 或 EGS 的风险显著降低相关。
结论
在这项主要来自美国的白人队列研究中，年龄增长和女性性别是 EG 或 EGS 的重要危险因素；然而，斯堪的纳维亚血统并非如此。与居住在美国北部地区相比，居住在美国中部或南部地区与 EG 或 EGS 的风险降低相关。
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