Cheng Qi, Saaddine Jinan B, Klein Ronald, Rothenberg Richard, Chou Chiu-Fang, Il'yasova Dora
a Department of Epidemiology and Biostatistics , Georgia State University School of Public Health , Atlanta , Georgia , USA.
b Division of Diabetes Translation , Centers for Disease Control and Prevention , Atlanta , Georgia , USA.
Ophthalmic Epidemiol. 2017 Dec;24(6):413-419. doi: 10.1080/09286586.2017.1337911. Epub 2017 Sep 11.
A cross sectional study was designed to examine the relationship of early age-related macular degeneration (AMD) with comorbidities of cardiovascular and renal conditions in the representative population using National Health and Nutrition Examination Survey (NHANES), 2005-2008.
Participants (≥40 years) who underwent retinal photography were included. Early AMD was defined by the retinal digital images. The comorbidities were self-reported stroke and heart disease (HD), including angina pectoris (AP), coronary heart disease (CHD), congestive heart failure (CHF), and myocardial infarction (MI). Chronic kidney disease (CKD) was determined based on self-report, estimation of glomerular filtration rate (GFR), or the level of urine albumin.
The age-adjusted odds ratio (OR) and 95% CI for having early AMD for persons with the selected conditions were: 2.6 (1.9, 3.6) for any type of HD. When the conditions were considered separately, ORs (95% CIs) were: 2.0 (1.2, 3.4) for AP; 2.5 (1.6, 3.8) for CHD; 2.4 (1.6, 3.6) for MI; 2.3 (1.3, 3.9) for CHF; 3.3 (2.2, 5.0) for stroke; and 2.4 (1.8, 3.2) for CKD. Covariable-adjusted ORs (AOR) were attenuated for all examined conditions, but remained statistically significant. Having any single condition (AOR [95%CI]: 2.7 [1.5, 4.8]) was significantly associated with early AMD, as was having ≥ 2 conditions (AOR [95%CI]: 5.2 [3.0, 9.0]). The strongest association was between early AMD and the combination of HD and stroke (AOR [95% CI]: 6.3 [2.9, 13.8]).
Cardiovascular and renal comorbidities are associated with early AMD in a representative sample of the US general population.
设计一项横断面研究，利用2005 - 2008年美国国家健康与营养检查调查（NHANES），在具有代表性的人群中研究早期年龄相关性黄斑变性（AMD）与心血管和肾脏疾病合并症之间的关系。
纳入接受视网膜摄影的参与者（≥40岁）。早期AMD由视网膜数字图像定义。合并症通过自我报告的中风和心脏病（HD）确定，包括心绞痛（AP）、冠心病（CHD）、充血性心力衰竭（CHF）和心肌梗死（MI）。慢性肾脏病（CKD）根据自我报告、肾小球滤过率（GFR）估计或尿白蛋白水平确定。
所选疾病患者患早期AMD的年龄调整优势比（OR）及95%置信区间（CI）为：任何类型的HD为2.6（1.9，3.6）。当分别考虑这些疾病时，OR（95%CI）分别为：AP为2.0（1.2，3.4）；CHD为2.5（1.6，3.8）；MI为2.4（1.6，3.6）；CHF为2.3（1.3，3.9）；中风为3.3（2.2，5.0）；CKD为2.4（1.8，3.2）。所有检查疾病的协变量调整OR（AOR）均有所减弱，但仍具有统计学意义。患有任何单一疾病（AOR[95%CI]：2.7[1.5，4.8]）与早期AMD显著相关，患有≥2种疾病时也是如此（AOR[95%CI]：5.2[3.0，9.0]）。最强的关联是早期AMD与HD和中风的组合之间（AOR[95%CI]：6.3[2.9，13.8]）。
在美国普通人群的代表性样本中，心血管和肾脏合并症与早期AMD相关。
