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终生暴露于环境紫外线辐射与白内障摘除及年龄相关性黄斑变性的风险:阿列诺研究

Lifetime exposure to ambient ultraviolet radiation and the risk for cataract extraction and age-related macular degeneration: the Alienor Study.

作者信息

Delcourt Cécile, Cougnard-Grégoire Audrey, Boniol Mathieu, Carrière Isabelle, Doré Jean-François, Delyfer Marie-Noëlle, Rougier Marie-Bénédicte, Le Goff Mélanie, Dartigues Jean-François, Barberger-Gateau Pascale, Korobelnik Jean-François

机构信息

Université de Bordeaux, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.

International Prevention Research Institute, Lyon, France.

出版信息

Invest Ophthalmol Vis Sci. 2014 Oct 21;55(11):7619-27. doi: 10.1167/iovs.14-14471.

Abstract

PURPOSE

While exposure to ultraviolet radiation (UVR) is a recognized risk factor for cataract, its association is more controversial with age-related macular degeneration (AMD). We report the associations of lifetime exposure to ambient UVR with cataract extraction and AMD.

METHODS

The Alienor Study is a population-based study of 963 residents of Bordeaux (France), aged 73 years or more. Lifetime exposure to ambient UVR was estimated from residential history and Eurosun satellite-based estimations of ground UVR. It was divided in three groups (lower quartile, intermediate quartiles, upper quartile), using the intermediate quartiles as the reference. Early and late AMD was classified from retinal color photographs. Cataract extraction was defined as absence of the natural lens at slit-lamp.

RESULTS

After multivariate adjustment, subjects in the upper quartile of lifetime ambient UVR exposure were at increased risk for cataract extraction (odds ratio [OR] = 1.53; 95% confidence interval [CI], 1.04-2.26; P = 0.03) and for early AMD (OR = 1.59; 95% CI, 1.04-2.44; P = 0.03), by comparison with subjects in the intermediate quartiles. Subjects in the lower quartile of UVR exposure also were at increased risk for early AMD (OR = 1.69; 95% CI, 1.06-2.69; P = 0.03), by comparison with those with medium exposure. Associations of late AMD with UVR exposure was not statistically significant.

CONCLUSIONS

This study further confirms the increased risk for cataract extraction in subjects exposed to high ambient UVR. Moreover, it suggests that risk for early AMD is increased in subjects exposed to high UVR, but also to low UVR, by comparison with medium exposures.

摘要

目的

虽然紫外线辐射(UVR)暴露是公认的白内障危险因素,但其与年龄相关性黄斑变性(AMD)的关联更具争议性。我们报告了终生环境UVR暴露与白内障摘除及AMD的关联。

方法

阿列诺研究是一项基于人群的研究,对象为963名年龄在73岁及以上的法国波尔多居民。根据居住史和基于Eurosun卫星的地面UVR估计值来估算终生环境UVR暴露量。将其分为三组(下四分位数、中间两个四分位数、上四分位数),以中间两个四分位数作为参照。根据视网膜彩色照片对早期和晚期AMD进行分类。白内障摘除定义为裂隙灯检查时无自然晶状体。

结果

经过多变量调整后,与处于中间两个四分位数的受试者相比,终生环境UVR暴露量处于上四分位数的受试者白内障摘除风险增加(比值比[OR]=1.53;95%置信区间[CI],1.04 - 2.26;P = 0.03),早期AMD风险增加(OR = 1.59;95%CI,1.04 - 2.44;P = 0.03)。与中等暴露量的受试者相比,UVR暴露量处于下四分位数的受试者早期AMD风险也增加(OR = 1.69;95%CI,1.06 - 2.69;P = 0.03)。晚期AMD与UVR暴露的关联无统计学意义。

结论

本研究进一步证实了暴露于高环境UVR的受试者白内障摘除风险增加。此外,研究表明,与中等暴露量相比,暴露于高UVR以及低UVR的受试者早期AMD风险均增加。

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