Rim Tyler Hyungtaek, Cheng Ching-Yu, Kim Dong Wook, Kim Sung Soo, Wong Tien Y
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Korea.
Br J Ophthalmol. 2017 Oct;101(10):1367-1373. doi: 10.1136/bjophthalmol-2016-309952. Epub 2017 Mar 14.
Few longitudinal studies have evaluated the relationship between cigarette smoking and risk of neovascular age-related macular degeneration (AMD) among Asian populations. This study aimed to prospectively evaluate the association between cigarette smoking and risk of neovascular AMD among Korean men.
Men between the ages of 45 and 79 years included in the Korea National Health Insurance Service database from 2002 through 2013. We compared hazard ratios (HR) for neovascular AMD between 64 560 past/current and 64 560 never smokers by 1:1 propensity-matched analysis and 85 267 past/current and 72 347 never smokers by unmatched cohort and propensity-adjusted analysis.
The risk of neovascular AMD among past/current smokers was 50% higher than that among never smokers (propensity-adjusted whole cohort analysis: HR, 1.48; 95% CI 1.22 to 1.79; propensity-matched analysis: HR, 1.50; 95% CI 1.22 to 1.84), with the risk more pronounced among current than past smokers (current vs past smokers: propensity-adjusted whole cohort analysis, HR, 1.66; 95% CI 1.35 to 2.04 vs HR, 1.15, 95% CI 0.87 to 1.52; propensity-matched analysis, HR, 1.65; 95% CI 1.32 to 2.05 vs HR, 1.21; 95% CI 0.90 to 1.63). Duration of smoking and daily cigarette consumption was associated with the incidence of neovascular AMD in a dose-dependent manner (p<0.001 for trend).
Cigarette smoking is associated with a strong risk of neovascular AMD among Korean men. These data highlight the public health impact of smoking on blindness in Asia.
很少有纵向研究评估亚洲人群中吸烟与新生血管性年龄相关性黄斑变性（AMD）风险之间的关系。本研究旨在前瞻性评估韩国男性中吸烟与新生血管性AMD风险之间的关联。
纳入2002年至2013年韩国国民健康保险服务数据库中年龄在45至79岁之间的男性。我们通过1:1倾向匹配分析比较了64560名既往/当前吸烟者与64560名从不吸烟者之间新生血管性AMD的风险比（HR），并通过未匹配队列和倾向调整分析比较了85267名既往/当前吸烟者与72347名从不吸烟者之间的风险比。
既往/当前吸烟者中新生血管性AMD的风险比从不吸烟者高50%（倾向调整的全队列分析：HR，1.48；95%CI 1.22至1.79；倾向匹配分析：HR，1.50；95%CI 1.22至1.84），当前吸烟者的风险比既往吸烟者更明显（当前吸烟者与既往吸烟者：倾向调整的全队列分析，HR，1.66；95%CI 1.35至2.04对HR，1.15，95%CI 0.87至1.52；倾向匹配分析，HR，1.65；95%CI 1.32至2.05对HR，1.21；95%CI 0.90至1.63）。吸烟持续时间和每日吸烟量与新生血管性AMD的发病率呈剂量依赖性相关（趋势p<0.001）。
吸烟与韩国男性中新生血管性AMD的高风险相关。这些数据突出了吸烟对亚洲失明的公共卫生影响。
