Pérez-de-Arcelus Mónica, Toledo Estefanía, Martínez-González Miguel Á, Martín-Calvo Nerea, Fernández-Montero Alejandro, Moreno-Montañés Javier
Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid IdiSNA, Navarra Institute for Health Research Department of Ophthalmology, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain.
Medicine (Baltimore). 2017 Jan;96(1):e5761. doi: 10.1097/MD.0000000000005761.
Smoking is a serious global public health concern that has been related to many chronic diseases. However, the effect of smoking on eye disorders has been less studied. The aim of this cohort study was to assess the association between current tobacco smokers and the risk of developing glaucoma and furthermore to evaluate the relationship between passive or former smokers and glaucoma.In this prospective and dynamic cohort, 16,797 participants initially who were found not to have glaucoma were followed up for a median of 8.5 years. Validated data on lifestyle, including tobacco consumption, were assessed at baseline. Information about new diagnosis of glaucoma was collected by follow-up questionnaires every 2 years. The outcome was the incidence of self-reported glaucoma during the follow-up. A subsample was used to validate the glaucoma diagnosis.During the 8.5 years of follow-up, 184 new glaucoma cases were identified. Current smokers had a significantly higher risk of glaucoma compared to participants who had never smoked after controlling for potential confounders (Hazard ratio [HR] 1.88 [95% coefficient interval (CI): 1.26-2.81]; P = 0.002). A nonsignificant increased risk was found among former smokers (HR 1.27 [95% CI: 0.88-1.82]; P = 0.198). When we assessed the exposure as per the number of cigarette pack-years, a dose-response relationship between pack-years and the risk of glaucoma was found (HR for the 5th quintile versus the 1st quintile: 1.70 [95% IC: 1.10-2.64], P for trend, 0.009). However, no relationship was found between passive smokers and glaucoma. (HR 0.67 [95% CI: 0.37-1.21]; P = 0.189).Our results suggest a direct association between current smokers and the incidence of glaucoma. In particular, this association was related to the number of pack-years, which was not found in the case of former smokers nor in the case of passive smokers.
吸烟是一个严重的全球公共卫生问题，与许多慢性疾病相关。然而，吸烟对眼部疾病的影响研究较少。这项队列研究的目的是评估当前吸烟者与患青光眼风险之间的关联，并进一步评估被动吸烟者或既往吸烟者与青光眼之间的关系。
在这个前瞻性动态队列中，最初发现16797名参与者没有青光眼，对他们进行了中位数为8.5年的随访。在基线时评估了包括烟草消费在内的生活方式的有效数据。每2年通过随访问卷收集有关青光眼新诊断的信息。结局是随访期间自我报告的青光眼发病率。使用一个子样本验证青光眼诊断。
在8.5年的随访期间，确定了184例新的青光眼病例。在控制潜在混杂因素后，当前吸烟者患青光眼的风险明显高于从未吸烟的参与者（风险比[HR]1.88[95%可信区间(CI)：1.26 - 2.81]；P = 0.002）。在既往吸烟者中发现风险有非显著性增加（HR 1.27[95%CI：0.88 - 1.82]；P = 0.198）。当我们根据吸烟包年数评估暴露情况时，发现吸烟包年数与青光眼风险之间存在剂量反应关系（第5五分位数与第1五分位数的HR：1.70[95%IC：1.10 - 2.64]，趋势P值为0.009）。然而，未发现被动吸烟者与青光眼之间存在关系（HR 0.67[95%CI：0.37 - 1.21]；P = 0.189）。
我们的结果表明当前吸烟者与青光眼发病率之间存在直接关联。特别是，这种关联与吸烟包年数有关，而在既往吸烟者和被动吸烟者中未发现这种情况。
