Ophthalmology, China Medical University, Taichung, Taiwan.
Ophthalmology, Fu-Jen Catholic University Hospital, New Taipei, Taiwan.
BMJ Open. 2019 Mar 23;9(3):e024209. doi: 10.1136/bmjopen-2018-024209.
To determine the prevalence and risk of systemic comorbidities in primary angle-closure glaucoma in Taiwan population.
We included 3322 primary angle-closure glaucoma (PACG) subjects and randomly selected patients without PACG from the Taiwan National Health Insurance Research Database and frequency matched four of them (n=13 288) to each PACG patient, based on age and sex. The univariable and multivariable unconditional logistic regression models were used to estimate the effect of comorbidities on the risk of PACG as indicated by the OR with 95% CI.
The mean age of the PACG group was 65.2±12.7 years, and 61.1% of the patients were female. The risk of PACG was greater for patients with the comorbidities of hyperlipidaemia (ORs: 1.11), headaches (ORs: 1.13), liver diseases (ORs: 1.14), peptic ulcers (ORs: 1.10) and cataract (ORs: 3.80). For the male group, diabetes (ORs: 1.19), liver diseases (ORs: 1.29) and cataract (ORs: 4.30) were significantly associated with increasing PACG risk. For the female group, hyperlipidaemia (ORs: 1.13), headaches (ORs: 1.15), peptic ulcers (ORs: 1.14) and cataract (ORs: 3.54) were significantly associated with increasing PACG risk. For the age group of 64 years and younger, patients with comorbidity of hyperlipidaemia (ORs: 1.20), peptic ulcers (ORs: 1.21) and cataract (ORs: 5.91) were significantly associated with increasing PACG risk. For the age group of 65 years and older, patients with cataract were significantly associated with increasing PACG risk (ORs: 5.07).
Clinicians should be aware of slightly increased PACG risk in the subjects with the medical comorbidities of hyperlipidaemia, headaches, liver diseases and peptic ulcers. However, cataract is the strongest risk factor of PACG.
确定台湾人群原发性闭角型青光眼（PACG）患者合并全身共病的患病率和风险。
我们纳入了 3322 例 PACG 患者，并从台湾全民健康保险研究数据库中随机选择无 PACG 的患者，并根据年龄和性别将他们与每例 PACG 患者进行频数匹配，每组 4 例（n=13288）。采用单变量和多变量非条件逻辑回归模型，以比值比（OR）及其 95%置信区间（CI）来估计共病对 PACG 风险的影响。
PACG 组患者的平均年龄为 65.2±12.7 岁，61.1%为女性。与无共病者相比，患有高脂血症（ORs：1.11）、头痛（ORs：1.13）、肝脏疾病（ORs：1.14）、消化性溃疡（ORs：1.10）和白内障（ORs：3.80）的 PACG 患者发生 PACG 的风险更高。对于男性患者，糖尿病（ORs：1.19）、肝脏疾病（ORs：1.29）和白内障（ORs：4.30）与 PACG 风险增加显著相关。对于女性患者，高脂血症（ORs：1.13）、头痛（ORs：1.15）、消化性溃疡（ORs：1.14）和白内障（ORs：3.54）与 PACG 风险增加显著相关。对于 64 岁及以下的年龄组，患有高脂血症（ORs：1.20）、消化性溃疡（ORs：1.21）和白内障（ORs：5.91）的患者发生 PACG 的风险显著增加。对于 65 岁及以上的年龄组，白内障患者发生 PACG 的风险显著增加（ORs：5.07）。
临床医生应注意到，患有高脂血症、头痛、肝脏疾病和消化性溃疡等合并症的 PACG 患者的 PACG 风险略有增加。然而，白内障是 PACG 的最强风险因素。
