Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung 40402, Taiwan.
Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung 40447, Taiwan.
Int J Environ Res Public Health. 2018 May 3;15(5):902. doi: 10.3390/ijerph15050902.
Direct evidence of whether thyroid cancer patients have a higher risk of age-related macular degeneration (AMD) has yet to be investigated. Patients older than 50 years-old and newly diagnosed with thyroid cancer between 2000 and 2008 were identified from the national health insurance research database (NHIRD). We applied time-varying Cox proportional hazard models to assess the association between thyroid cancer and AMD. The multivariable models included conventional cardiovascular risk factors, myopia, vitreous floaters, hypothyroidism, hyperthyroidism, and treatment modality of thyroid cancer. The analysis process was stratified by age, gender, and comorbidity. In this study, 5253 patients were included in a thyroid cancer cohort (men 24.5%; median age 59.1 years (53.7⁻67.4 years), and 21,012 matched controls were included in a non-thyroid cancer cohort. The AMD incidence was 40.7 per 10,000 person/year in the thyroid cancer cohort. The thyroid cancer cohort had a higher risk (adjusted hazard ratio (aHR) = 1.38, 95% confidence interval, CI = 1.09⁻1.75) of AMD than the non-thyroid cohort. Thyroid cancer patients had a higher risk of AMD, especially the male patients (aHR = 1.92, 95% CI = 1.38⁻3.14) and the patients with comorbidities (aHR = 1.38, 95% CI = 1.09⁻1.74). In conclusion, thyroid cancer patients older than 50 years-old have increased risk of AMD.
尚未有直接证据表明甲状腺癌患者是否存在更高的年龄相关性黄斑变性(AMD)风险。从国家健康保险研究数据库(NHIRD)中确定了 2000 年至 2008 年间年龄大于 50 岁且新诊断为甲状腺癌的患者。我们应用时变 Cox 比例风险模型来评估甲状腺癌与 AMD 之间的关联。多变量模型包括常规心血管危险因素、近视、玻璃体浮游物、甲状腺功能减退症、甲状腺功能亢进症以及甲状腺癌的治疗方式。分析过程按年龄、性别和合并症进行分层。在这项研究中,5253 名患者被纳入甲状腺癌队列(男性占 24.5%;中位年龄 59.1 岁(53.7⁻67.4 岁),21012 名匹配的对照者被纳入非甲状腺癌队列。甲状腺癌队列中 AMD 的发病率为 40.7/10000 人/年。与非甲状腺癌队列相比,甲状腺癌队列发生 AMD 的风险更高(调整后的风险比[aHR] = 1.38,95%置信区间[CI] = 1.09⁻1.75)。甲状腺癌患者发生 AMD 的风险更高,尤其是男性患者(aHR = 1.92,95%CI = 1.38⁻3.14)和合并症患者(aHR = 1.38,95%CI = 1.09⁻1.74)。总之,年龄大于 50 岁的甲状腺癌患者发生 AMD 的风险增加。