老年人群中共病风险与视网膜静脉阻塞诊断之间的双向关联：一项基于全国人口的研究。

Bidirectional association between the risk of comorbidities and the diagnosis of retinal vein occlusion in an elderly population: a nationwide population-based study.

作者信息

Shih Chia-Hsiang, Ou Shu-Yu, Shih Chia-Jen, Chen Yung-Tai, Ou Shuo-Ming, Lee Yi-Jung

机构信息

Department of Emergency, Kuang Tien General Hospital, Taichung, Taiwan.

School of Medicine, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Taiwan.

出版信息

Int J Cardiol. 2015 Jan 15;178:256-61. doi: 10.1016/j.ijcard.2014.10.110. Epub 2014 Oct 22.

DOI:10.1016/j.ijcard.2014.10.110

PMID:25464265

Abstract

BACKGROUND

Retinal vein occlusion (RVO) is the second most common retinal vascular disease, with peak incidence at 70years of age. However, the bidirectional association between the risk of comorbidities and the diagnosis of RVO in this population is uncertain.

METHODS

A population-based cohort of 1,784,960 patients 70years of age and older retrieved from the Taiwan National Health Insurance Research Database between 2000 and 2010. Risks of comorbidities were assessed 5years before and after the diagnosis of RVO.

RESULTS

In our study, 3393 subjects had central RVO (CRVO) and 6688 subjects had branch RVO (BRVO). Before the diagnosis of RVO, patients showed increased risks for the following comorbidities: hypertension (odds ratio [OR]=1.83, 95% confidence interval [CI], 1.74-1.93), dyslipidemia (OR=1.29, [1.23-1.35]), DM (OR=1.29, [1.23-1.35]), liver disease (OR=1.22, [1.16-1.29]), renal disease (OR=1.30, [1.23-1.37]), and cerebrovascular disease (OR=1.16, [1.11-1.21]). After the diagnosis of RVO, patients were at greater risk of developing DM (adjusted hazard ratio [AHR]=1.12, [1.06-1.19]), PAD (AHR=1.17, [1.08-1.27]), and MACE (AHR=1.35, [1.25-1.46]); however, the risk of all-cause mortality was unchanged. Elderly patients with CRVO had a significantly higher risk of all-cause mortality (AHR=1.09, [1.02-1.17]), whereas patients with BRVO showed no significant differences in mortality.

CONCLUSION

This study suggests bidirectional association between the risk of comorbidities and the diagnosis of RVO in an elderly population.

摘要

背景

视网膜静脉阻塞（RVO）是第二常见的视网膜血管疾病，发病高峰年龄为70岁。然而，该人群中共病风险与RVO诊断之间的双向关联尚不确定。

方法

基于人群的队列研究，纳入2000年至2010年间从台湾国民健康保险研究数据库中检索出的1,784,960名70岁及以上的患者。在RVO诊断前后5年评估共病风险。

结果

在我们的研究中，3393名受试者患有中央视网膜静脉阻塞（CRVO），6688名受试者患有分支视网膜静脉阻塞（BRVO）。在RVO诊断之前，患者出现以下共病的风险增加：高血压（比值比[OR]=1.83，95%置信区间[CI]，1.74 - 1.93）、血脂异常（OR=1.29，[1.23 - 1.35]）、糖尿病（OR=1.29，[1.23 - 1.35]）、肝病（OR=1.22，[1.16 - 1.29]）、肾病（OR=1.30，[1.23 - 1.37]）和脑血管疾病（OR=1.16，[1.11 - 1.21]）。在RVO诊断之后，患者发生糖尿病（调整后风险比[AHR]=1.12，[1.06 - 1.19]）、外周动脉疾病（AHR=1.17，[1.08 - 1.27]）和主要不良心血管事件（AHR=1.35，[1.25 - 1.46]）的风险更高；然而，全因死亡率风险未改变。老年CRVO患者的全因死亡率风险显著更高（AHR=1.09，[1.02 - 1.17]），而BRVO患者的死亡率无显著差异。