González Marta Mora, Solano Marissé Masís, Porco Travis C, Oldenburg Catherine E, Acharya Nisha R, Lin Shan C, Chan Matilda F
Department of Ophthalmology, University of California, San Francisco, 10 Koret Way, San Francisco, CA, 94143, USA.
F.I. Proctor Foundation, University of California, San Francisco, 513 Parnassus Avenue, San Francisco, CA, 94122, USA.
J Ophthalmic Inflamm Infect. 2018 Apr 17;8(1):6. doi: 10.1186/s12348-018-0148-5.
The purpose of this study is to assess the relationship between self-reported uveitis and purported demographic and clinical risk factors, using an American adult population extracted from the National Health and Nutrition Examination Survey (NHANES) for the years 2009 and 2010. This is a cross-sectional, population-based study using a sample of 5106 subjects between 20 and 69 years old. The main outcome for our study was the self-report of a diagnosis of uveitis. The demographic analysis included age, gender, and ethnicity. Potential predictors were having a diagnosis of ankylosing spondylitis (AS), ulcerative colitis (UC), or Crohn's disease (CD); a history of cigarette smoking; vitamin D deficiency; and different mental health measures. Univariate and multivariate analyses were conducted using RStudio.
Of the 5106 participants, 27 had reported a diagnosis of uveitis, showing an adjusted prevalence of 5.4 per 1000 subjects (95% CI 3.4-8.5/1000). Increased age was associated with higher uveitis prevalence in the multivariate analysis (odds ratio [OR] = 1.04, 95% CI 1.01-1.07; p = 0.02). Positive smoking history was reported in 59.2% of patients. Multivariate analysis comparing smoking with the presence of uveitis showed an OR of 3.18 (95% CI 1.59-6.37; p = 0.003), adjusting for age and gender. Moreover, 11.1% of the participants from the uveitis group self-reported a diagnosis of AS and 11.7% informed a diagnosis of UC and 7.1% of CD. The ORs were of 16.64 (95% CI 3.64-76.09; p = 0.001), 11.34 (95% CI 2.69-47.88; p = 0.003), and 22.16 (95% CI 2.64-186.17; p = 0.007), respectively when compared with the non-uveitis group in the multivariate analysis.
Age, cigarette smoking, AS, UC, and CD are positively associated with self-reported uveitis. There is previous evidence that smoking and female gender are positive risk factors for uveitis, as well as evidence that HLA-B27-positive spondyloarthritides have the highest association with non-infectious uveitis in the adult population in North America and Europe. However, there are no prior studies that have utilized a representative US population-based sample to validate these findings. The present study supports smoking as a risk factor, which has clinical relevance since this is a modifiable habit.
本研究旨在利用从2009年和2010年美国国家健康与营养检查调查（NHANES）中提取的成年人群，评估自我报告的葡萄膜炎与所谓的人口统计学和临床风险因素之间的关系。这是一项基于人群的横断面研究，样本为5106名年龄在20至69岁之间的受试者。我们研究的主要结果是自我报告的葡萄膜炎诊断。人口统计学分析包括年龄、性别和种族。潜在预测因素包括诊断为强直性脊柱炎（AS）、溃疡性结肠炎（UC）或克罗恩病（CD）；吸烟史；维生素D缺乏；以及不同的心理健康指标。使用RStudio进行单变量和多变量分析。
在5106名参与者中，有27人报告诊断为葡萄膜炎，调整后的患病率为每1000名受试者中有5.4例（95%可信区间3.4 - 8.5/1000）。在多变量分析中，年龄增加与葡萄膜炎患病率升高相关（优势比[OR]=1.04，95%可信区间1.01 - 1.07；p = 0.02）。59.2%的患者报告有阳性吸烟史。在多变量分析中，比较吸烟与葡萄膜炎的存在情况，在调整年龄和性别后，OR为3.18（95%可信区间1.59 - 6.37；p = 0.003）。此外，葡萄膜炎组中11.1%的参与者自我报告诊断为AS，11.7%报告诊断为UC，7.1%报告诊断为CD。在多变量分析中，与非葡萄膜炎组相比，OR分别为16.64（95%可信区间3.64 - 76.09；p = 0.001）、11.34（95%可信区间2.69 - 47.88；p = 0.003）和22.16（95%可信区间2.64 - 186.17；p = 0.007）。
年龄、吸烟、AS、UC和CD与自我报告的葡萄膜炎呈正相关。以前有证据表明吸烟和女性性别是葡萄膜炎的阳性风险因素，还有证据表明在北美和欧洲的成年人群中，HLA - B27阳性的脊柱关节炎与非感染性葡萄膜炎的关联最高。然而，以前没有研究利用具有代表性的美国人群样本验证这些发现。本研究支持吸烟作为一个风险因素，这具有临床相关性，因为这是一个可改变的习惯。
