阻塞性睡眠呼吸暂停与青光眼风险增加：基于人群的匹配队列研究。

Obstructive sleep apnea and increased risk of glaucoma: a population-based matched-cohort study.

机构信息

Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.

出版信息

Ophthalmology. 2013 Aug;120(8):1559-64. doi: 10.1016/j.ophtha.2013.01.006. Epub 2013 Apr 17.

DOI:10.1016/j.ophtha.2013.01.006

PMID:23601803

Abstract

PURPOSE

Previous studies had reported an increased prevalence of glaucoma in patients with obstructive sleep apnea (OSA). However, the risk of open-angle glaucoma (OAG) among patients with OSA remains unclear. Using a nationwide, population-based dataset in Taiwan, this study aimed to examine the prevalence and risk of OAG among patients with OSA during a 5-year follow-up period after a diagnosis of OSA.

DESIGN

A retrospective, matched-cohort study.

PARTICIPANTS AND CONTROLS

This study used data sourced from the Longitudinal Health Insurance Database 2000. We included 1012 subjects with OSA in the study cohort and randomly selected 6072 subjects in the comparison group.

METHODS

Each subject in this study was individually traced for a 5-year period to identify those subjects who subsequently received a diagnosis of OAG. Cox proportional hazards regression was performed to calculate the 5-year risk of OAG between the study and comparison cohorts.

MAIN OUTCOME MEASURES

The incidence and risk of OAG between the study and comparison groups.

RESULTS

During the 5-year follow-up period, the incidence rate per 1000 person-years was 11.26 (95% confidence interval [CI], 8.61-14.49) and 6.76 (95% CI, 5.80-7.83) for subjects with and without OSA, respectively. After adjusting for monthly income, geographic region, diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, renal disease, hypothyroidism, and the number of outpatient visits for ophthalmologic care during the follow-up period, stratified Cox proportional hazards regression revealed that the hazard ratio for OAG within the 5-year period for subjects with OSA was 1.67 (95% CI, 1.30-2.17; P<0.001) that of comparison subjects.

CONCLUSIONS

Our results suggest that OSA is associated with an increased risk of subsequent OAG diagnosis during a 5-year follow-up period.

FINANCIAL DISCLOSURES(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.

摘要

目的

先前的研究报告称，阻塞性睡眠呼吸暂停（OSA）患者中青光眼的患病率增加。然而，OSA 患者发生开角型青光眼（OAG）的风险仍不清楚。本研究使用台湾一个全国性的基于人群的数据集，旨在检查 OSA 诊断后 5 年的随访期间 OSA 患者中 OAG 的患病率和风险。

设计

回顾性匹配队列研究。

参与者和对照

本研究使用来自 2000 年纵向健康保险数据库的数据。我们将研究队列中的 1012 名 OSA 患者和随机选择的 6072 名对照患者纳入研究。

方法

对每位患者进行个体追踪 5 年，以确定随后被诊断为 OAG 的患者。使用 Cox 比例风险回归计算研究队列和对照组之间 5 年内 OAG 的风险。

主要观察指标

研究组和对照组之间 OAG 的发生率和风险。

结果

在 5 年的随访期间，OSA 患者和无 OSA 患者的人年发病率分别为 11.26（95%置信区间[CI]，8.61-14.49）和 6.76（95% CI，5.80-7.83）。在校正月收入、地理区域、糖尿病、高血压、冠心病、肥胖症、高脂血症、肾脏疾病、甲状腺功能减退症以及随访期间眼科就诊次数后，分层 Cox 比例风险回归显示，OSA 患者 OAG 在 5 年内的风险比为 1.67（95%CI，1.30-2.17；P<0.001），高于对照组。