Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Institutes of Environmental Medicine, School of Medicine, Zhejiang University, Hangzhou, China.
PLoS One. 2014 Dec 4;9(12):e114012. doi: 10.1371/journal.pone.0114012. eCollection 2014.
Cataract is the major cause of blindness across the world. Many epidemiologic studies indicated that hypertension might play an important role in the development of cataract, while others not. We therefore conducted this meta-analysis to determine the relationship between risk of cataract and hypertension.
Retrieved studies on the association of hypertension with cataract risk were collected from PubMed, Web of Science and the Cochrane Library during June 2014 and were included into the final analysis according to the definite inclusion criteria. Odds ratio (OR) or risk ratio (RR) were pooled with 95% confidence interval (CI) to evaluate the relationship between hypertension and cataract risk. Subgroup analyses were carried out on the basis of cataract type, race and whether studies were adjusted for main components of metabolic syndrome (MS).
The final meta-analysis included 25 studies (9 cohort, 5 case-control and 11 cross-sectional) from 23 articles. The pooled results showed that cataract risk in populations with hypertension significantly increased among cohort studies (RR 1.08; 95% CI: 1.05-1.12) and case-control or cross-sectional studies (OR 1.28; 95% CI: 1.12-1.45). This association was proved to be true among both Mongolians and Caucasians, and the significance was not altered by the adjustment of main components of MS. Subgroup analysis on cataract types indicated that an increased incidence of posterior subcapsular cataract (PSC) resulted among cohort studies (RR 1.22; 95% CI: 1.03-1.46) and cross-sectional/case-control studies (OR 1.23; 95% CI: 1.09-1.39). No association of hypertension with risk of nuclear cataract was found.
The present meta-analysis suggests that hypertension increases the risk of cataract, especially PSC. Further efforts should be made to explore the potential biological mechanisms.
白内障是全球致盲的主要原因。许多流行病学研究表明，高血压可能在白内障的发生发展中起重要作用，但也有其他研究结果不一致。因此，我们进行了这项荟萃分析，以确定白内障与高血压之间的关系。
我们从 PubMed、Web of Science 和 Cochrane Library 中检索了 2014 年 6 月之前关于高血压与白内障风险关系的研究，并根据明确的纳入标准将这些研究纳入最终分析。使用比值比（OR）或风险比（RR）及其 95%置信区间（CI）来评估高血压与白内障风险之间的关系。根据白内障类型、种族以及研究是否校正了代谢综合征（MS）的主要成分，进行了亚组分析。
最终的荟萃分析纳入了 23 篇文章中的 25 项研究（9 项队列研究、5 项病例对照研究和 11 项横断面研究）。汇总结果显示，队列研究（RR 1.08；95% CI：1.05-1.12）和病例对照或横断面研究（OR 1.28；95% CI：1.12-1.45）中，高血压人群的白内障风险显著增加。这种相关性在蒙古人和高加索人中都是真实存在的，且不受 MS 主要成分校正的影响。白内障类型的亚组分析表明，队列研究（RR 1.22；95% CI：1.03-1.46）和横断面/病例对照研究（OR 1.23；95% CI：1.09-1.39）中后囊下白内障（PSC）的发生率增加。高血压与核性白内障风险之间无关联。
本荟萃分析提示高血压增加了白内障的风险，尤其是 PSC。应进一步努力探索潜在的生物学机制。
