Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Ophthalmology. 2012 Oct;119(10):2040-7. doi: 10.1016/j.ophtha.2012.05.001. Epub 2012 Jul 6.
To identify sociodemographic and biological risk factors associated with the 4-year incidence of nuclear, cortical, posterior subcapsular (PSC), and mixed lens opacities.
Population-based, longitudinal study.
We included 4658 Latinos ≥40 years from 6 census tracts in Los Angeles, California.
Participants underwent an interview and detailed eye examination, including best-corrected visual acuity and slit-lamp assessment of lens opacities using the Lens Opacities Classification System II (LOCS II) at baseline and again 4 years later. Each opacity type was defined in persons with a LOCS II score of ≥2. Univariate and forward stepwise logistic regression analyses were used to identify independent baseline risk factors associated with 4-year incidence of nuclear only, cortical only, PSC only, and mixed (when >1 opacity type developed in a person) lens opacities. These comprised 4 mutually exclusive groups, and were based on person rather than eye.
Odds ratios for independent risk factors associated with 4-year incidence of nuclear-only, cortical-only, PSC-only, and mixed lens opacities.
Of the 3471 participants with gradable lenses in the same eye at baseline and 4-year follow-up, 200 (5.8%) had incident nuclear-only opacities, 151 (4.1%) had incident cortical-only opacities, 16 (0.5%) had incident PSC-only lens opacities, and 88 (2.5%) had mixed lens opacities. Independent baseline risk factors for incident nuclear-only lens opacities included older age, current smoking, and presence of diabetes. Independent risk factors for incident cortical-only lens opacities included older age and having diabetes at baseline. Female gender was an independent risk factor for incident PSC-only lens opacities. Older age and presence of diabetes at baseline examination were independent risk factors for incident mixed lens opacities. Specifically, in diabetics, higher levels of hemoglobin A1c was associated with greater risk for 4-year incident nuclear-only, cortical-only and mixed lens opacities.
Improved diabetic control and smoking prevention may reduce the risk of developing lens opacities. Understanding both modifiable and nonmodifiable risk factors provides insight into the development of lens opacification.
确定与核性、皮质性、后囊下（PSC）和混合性晶状体混浊的 4 年发生率相关的社会人口学和生物学危险因素。
基于人群的纵向研究。
我们纳入了加利福尼亚州洛杉矶 6 个普查区的 4658 名年龄≥40 岁的拉丁裔人。
参与者接受了访谈和详细的眼部检查，包括最佳矫正视力和使用 Lens Opacities Classification System II (LOCS II) 在基线和 4 年后对晶状体混浊进行裂隙灯评估。每种混浊类型均定义为 LOCS II 评分≥2 的人。使用单变量和逐步向前逻辑回归分析确定与核性仅、皮质性仅、PSC 性仅和混合性（当一个人出现>1 种混浊类型时）晶状体混浊的 4 年发生率相关的独立基线危险因素。这些包括 4 个相互排斥的组，基于个体而不是眼睛。
与核性仅、皮质性仅、PSC 性仅和混合性晶状体混浊的 4 年发生率相关的独立危险因素的比值比。
在基线和 4 年随访时可对同一眼进行分级的 3471 名参与者中，200 名（5.8%）发生了核性仅混浊，151 名（4.1%）发生了皮质性仅混浊，16 名（0.5%）发生了 PSC 性仅混浊，88 名（2.5%）发生了混合性晶状体混浊。与核性仅晶状体混浊发生相关的独立基线危险因素包括年龄较大、当前吸烟和患有糖尿病。与皮质性仅晶状体混浊发生相关的独立危险因素包括年龄较大和基线时患有糖尿病。女性是 PSC 性仅晶状体混浊发生的独立危险因素。年龄较大和基线检查时患有糖尿病是混合性晶状体混浊发生的独立危险因素。具体而言，在糖尿病患者中，糖化血红蛋白水平升高与 4 年内核性仅、皮质性仅和混合性晶状体混浊的发生率增加相关。
改善糖尿病控制和预防吸烟可能会降低晶状体混浊的风险。了解可改变和不可改变的危险因素可深入了解晶状体混浊的发生机制。
