Lu Zhi-Quan, Sun Wen-Hui, Yan Jia, Jiang Teng-Xuan, Zhai Shu-Na, Li Yan
Department of Epidemiology, Liaoning Medical University, Jinzhou 121001, Liaoning Province, China.
Int J Ophthalmol. 2012;5(3):317-22. doi: 10.3980/j.issn.2222-3959.2012.03.13. Epub 2012 Jun 18.
To determine the association between cigarettes smoking, body mass index (BMI) and the risk of age-related cataract (ARC) in middle-aged and elderly men in Northeast China.
A hospital-based case control study was conducted. Cases (n =362) were men who had surgically treated ARC, 45-85 years old; controls frequency-matched (n =362) were men who had been admitted to the same hospital as cases for other diseases not related with eye diseases. Cases and controls were matched with 1:1. The cases and controls were interviewed during their hospital stay, using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, socioeconomic, lifestyle habits (tobacco smoking and alcohol consumption, etc.), anthropometric measures, personal medical history, and family history of ARC in first-degree relatives, and simultaneously BMI was calculated. The odds ratios (OR) and 95% confidence intervals (CI) of ARC were estimated using multiple logistic regression models.
After adjusting for age and multiple potential confounders, higher BMI was associated with an increased risk of ARC. Cigarette smoking, years smoking or moderate cigarette smoking (1-29 cigarettes per day) had no relation with the risk of ARC (P>0.05), although patients smoking ≥30 cigarettes per day had an elevated risk of ARC as compared with the non-smokers (OR=1.55, 95% CI; 1.16-2.85, P=0.026). Higher BMI was associated with an increased risk of ARC. Both overweight and obesity was associated with an obviously increased risk for surgically ARC (OR=1.55, 95% CI: 1.02-1.98, P=0.015 and OR=1.71, 95% CI: 1.32-2.39, P=0.013 respectively) compared to normal BMI. Then participants were grouped into quartiles of BMI (Q1 to Q4), compared to controls in the lowest quartile, the OR for cases in the highest quartile of BMI was 1.54 (OR=1.54, 95% CI: 1.08-2.46, P=0.022). The results of univariate analysis showed cigarette smoking was not associated with ARC formation for men with lower or normal BMI (P>0.05). Compared to the non-smokers, for men of overweight or obesity, cigarette smoking was associated with a significantly increased risk for surgically ARC (OR=2.00, 95% CI: 1.49-6.65, P=0.003 and OR=1.66, 95% CI: 1.63-13.21, P=0.002 respectively). Similarly, smokers in the highest quartile of BMI had approximately 1.5 times the risk of ARC as non-smokers in the lowest quartile (OR=1.46, 95% CI: 1.06-5.29, P<0.001). Followed multivariate models revealed that the association had never changed.
Current cigarette smoking is positively related to ARC only among those who smoking 30 or more cigarettes per day. For men who are both overweight and obesity, cigarette smoking is associated with a significantly increased risk for ARC.
确定中国东北地区中老年男性吸烟、体重指数(BMI)与年龄相关性白内障(ARC)风险之间的关联。
开展一项基于医院的病例对照研究。病例组(n = 362)为接受过ARC手术治疗的45 - 85岁男性;对照组(n = 362)为因其他非眼部疾病与病例组在同一医院就诊的男性,病例组与对照组按1:1进行频率匹配。在病例组和对照组住院期间进行访谈,使用结构化访谈问卷,内容包括社会人口学特征、社会经济状况、生活方式习惯(吸烟和饮酒等)、人体测量指标、个人病史以及一级亲属ARC家族史,并同时计算BMI。使用多因素逻辑回归模型估计ARC的比值比(OR)和95%置信区间(CI)。
在调整年龄和多个潜在混杂因素后,较高的BMI与ARC风险增加相关。吸烟、吸烟年限或中度吸烟(每天1 - 29支)与ARC风险无关(P>0.05),尽管每天吸烟≥30支的患者与不吸烟者相比,ARC风险升高(OR = 1.55,95%CI:1.16 - 2.85,P = 0.026)。较高的BMI与ARC风险增加相关。与正常BMI相比,超重和肥胖均与手术治疗ARC的风险显著增加相关(分别为OR = 1.55,95%CI:1.02 - 1.98,P = 0.015和OR = 1.71,95%CI:1.32 - 2.39,P = 0.013)。然后将参与者按BMI四分位数分组(Q1至Q4),与最低四分位数的对照组相比,BMI最高四分位数的病例组OR为1.54(OR =