戒烟与白内障风险：一项针对男性白内障摘除的前瞻性队列研究。

Smoking cessation and the risk of cataract: a prospective cohort study of cataract extraction among men.

机构信息

Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden2School of Health and Medical Sciences, Örebro University, Örebro, Sweden3Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

出版信息

JAMA Ophthalmol. 2014 Mar;132(3):253-7. doi: 10.1001/jamaophthalmol.2013.6669.

DOI:10.1001/jamaophthalmol.2013.6669

PMID:24385206

Abstract

IMPORTANCE

Smoking is a risk factor for cataract development, but the effect of smoking cessation on the risk of cataract is uncertain.

OBJECTIVE

To examine the association between smoking cessation and the risk of cataract extraction.

DESIGN, SETTING, AND PARTICIPANTS: A total of 44,371 men, participating in the Cohort of Swedish Men, aged 45 to 79 years, who in 1997 completed a self-administered questionnaire on smoking habits and lifestyle factors. The men were followed up from January 1, 1998, through December 31, 2009. The cohort was matched with the Swedish National Day-Surgery Register and local registers of cataract extraction in the study area.

MAIN OUTCOMES AND MEASURES

Incident cases of age-related cataract extraction.

RESULTS

During 12 years of follow-up, we identified 5713 incident cases of age-related cataract extraction. Smoking intensity and cumulative dose of smoking were associated with an increased risk of cataract extraction (P for trend <.001). Current smokers of more than 15 cigarettes per day had a 42% increased risk of cataract extraction (rate ratio, 1.42; 95% CI, 1.28-1.58) compared with never smokers after adjustment for age and other potential risk factors. Smoking cessation significantly decreased the risk for cataract extraction with time (P for trend <.001). After more than 20 years since stopping smoking, men with a mean smoking intensity of more than 15 cigarettes per day had a 21% increased risk of cataract extraction (rate ratio, 1.21; 95% CI, 1.06-1.39) compared with never smokers. Among men who smoked 15 cigarettes or less per day, the effect of smoking cessation was observed earlier, but more than 2 decades after smoking cessation, the risk of cataract extraction did not decrease to the level of never smokers (rate ratio, 1.13; 95% CI, 1.04-1.24).

CONCLUSIONS AND RELEVANCE

Smoking cessation seems to decrease the risk of cataract extraction with time, although the risk persists for decades. The higher the intensity of smoking, the longer it takes for the increased risk to decline. These findings emphasize the importance of early smoking cessation and preferably the avoidance of smoking.

摘要

重要性

吸烟是白内障发展的一个风险因素，但戒烟对白内障风险的影响尚不确定。

目的

研究戒烟与白内障摘除风险之间的关联。

设计、地点和参与者：共有 44371 名 45 至 79 岁的男性参加了瑞典男性队列研究，他们于 1997 年完成了一份关于吸烟习惯和生活方式因素的自我管理问卷。从 1998 年 1 月 1 日至 2009 年 12 月 31 日，对这些男性进行了随访。该队列与瑞典全国日间手术登记处以及研究区域的白内障摘除地方登记处相匹配。

主要结果和措施

年龄相关性白内障摘除的发病情况。

结果

在 12 年的随访期间，我们共发现 5713 例年龄相关性白内障摘除病例。吸烟强度和吸烟累计剂量与白内障摘除风险增加相关（趋势 P<0.001）。与从不吸烟者相比，每天吸烟超过 15 支的当前吸烟者白内障摘除风险增加 42%（比率比，1.42；95%CI，1.28-1.58），校正年龄和其他潜在风险因素后。随着时间的推移，戒烟显著降低了白内障摘除的风险（趋势 P<0.001）。停止吸烟 20 多年后，每天吸烟超过 15 支的男性白内障摘除风险比从不吸烟者增加 21%（比率比，1.21；95%CI，1.06-1.39）。对于每天吸烟 15 支或以下的男性，戒烟的效果更早出现，但戒烟 20 多年后，白内障摘除的风险并未降至从不吸烟者的水平（比率比，1.13；95%CI，1.04-1.24）。