Wong Mark Yu Zheng, Man Ryan Eyn Kidd, Gupta Preeti, Lim Sing Hui, Lim Blanche, Tham Yih-Chung, Sabanayagam Charumathi, Wong Tien Yin, Cheng Ching-Yu, Lamoureux Ecosse Luc
Singapore Eye Research Institute, Singapore.
Singapore National Eye Centre, Singapore.
Am J Ophthalmol. 2017 Nov;183:99-106. doi: 10.1016/j.ajo.2017.09.002. Epub 2017 Sep 11.
To examine the longitudinal relationship between baseline corneal arcus (CA) and incident cardiovascular disease (CVD) in ethnic Indian and Malay adults in Singapore.
Population-based cohort study.
Indian and Malay adults aged 40-80 years were recruited for baseline and 6-year follow-up visits between 2004-2009 and 2010-2015, respectively (follow-up response rate 73.9%). CA was assessed by ophthalmologists using slit-lamp biomicroscopy. The main outcome was self-reported incident CVD, defined as new myocardial infarction, angina pectoris, or stroke, which developed between baseline and follow-up. Multivariable logistic regression models assessed independent associations between baseline CA and incident CVD, adjusting for traditional CVD risk factors including age, sex, serum cholesterol, hypertension, diabetes, and smoking. We further conducted sex-stratified analyses to identify possible effect modifications.
Of the total 3637 participants (overall mean [SD] age: 56 [9] years, 46% male) with available follow-up data, without history of CVD at baseline, 208 (5.7%) incident CVD cases were reported. Participants with CA were more likely to have incident CVD (7.5%) than those without (4.9%). After controlling for traditional CVD risk factors, CA was independently associated with incident CVD (odds ratio [95% confidence interval]: 1.52 [1.07-2.16]) in adjusted models. In sex-stratified models, associations between CA and incident CVD were seen in men (1.73 [1.12-2.67]) and not in women (1.05 [0.56-1.97]).
CA is associated with incident CVD, independent of serum lipids and traditional CVD risk factors, in ethnic Malay and Indian men. Our finding suggests that CA is an additional observable indicator of CVD in men.
研究新加坡印度族和马来族成年人基线角膜弓（CA）与心血管疾病（CVD）发病之间的纵向关系。
基于人群的队列研究。
分别于2004 - 2009年和2010 - 2015年招募年龄在40 - 80岁的印度族和马来族成年人进行基线和6年随访（随访应答率73.9%）。眼科医生使用裂隙灯生物显微镜评估CA。主要结局是自我报告的CVD发病，定义为基线和随访期间发生的新发心肌梗死、心绞痛或中风。多变量逻辑回归模型评估基线CA与CVD发病之间的独立关联，并对包括年龄、性别、血清胆固醇、高血压、糖尿病和吸烟在内的传统CVD危险因素进行调整。我们进一步进行了性别分层分析，以确定可能的效应修饰因素。
在有可用随访数据、基线时无CVD病史的3637名参与者（总体平均[标准差]年龄：56[9]岁，46%为男性）中，报告了208例（5.7%）CVD发病病例。有CA的参与者发生CVD的可能性（7.5%）高于无CA的参与者（4.9%）。在控制了传统CVD危险因素后，在调整模型中，CA与CVD发病独立相关（比值比[95%置信区间]：1.52[1.07 - 2.16]）。在性别分层模型中，CA与CVD发病之间的关联在男性中可见（1.73[1.12 - 2.67]），而在女性中未见（1.05[0.56 - 1.97]）。
在马来族和印度族男性中，CA与CVD发病相关，独立于血脂和传统CVD危险因素。我们的发现表明，CA是男性CVD的另一个可观察指标。
