Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Sci Rep. 2021 Jan 11;11(1):398. doi: 10.1038/s41598-020-79865-z.
The longitudinal relationship between smoking status and risk of developing visual impairment (VI) remains unclear. We examined the relationship of smoking status and urinary cotinine level, an objective measure of smoking, with incidence of VI. This cohort study included 279,069 individuals free of VI who were followed for up to 8.8 years (median 4.8 years). VI was defined as when bilateral visual acuity was worse than 0.5 (cutoffs of 0.3 Logarithm of the Minimum Angle of Resolution). During 1,324,429.8 person-years of follow-up, 7852 participants developed new-onset bilateral VI. Self-reported current smoking status was associated with increased risk of developing VI in both men and women, with a stronger association in women (P for interaction = 0.01). Multivariable adjusted hazard ratios (95% confidence intervals) for incident VI comparing current smokers to never-smokers were 1.14 (1.04-1.25) in men and 1.52 (1.28-1.80) in women. Urinary cotinine levels of ≥ 100 ng/ml were significantly associated with increased risk of incident VI, and these associations remained when introducing changes in urinary cotinine and other confounders during follow-up as time-varying covariates. Cigarette smoking assessed based on self-report and urinary cotinine level was associated with increased incidence of VI. Our findings identify smoking as an independent risk factor for VI.
吸烟状况与视力损害（VI）发展风险之间的纵向关系尚不清楚。我们研究了吸烟状况和尿可替宁水平（吸烟的客观衡量标准）与 VI 发病率之间的关系。这项队列研究包括 279069 名无 VI 的个体，随访时间长达 8.8 年（中位数 4.8 年）。VI 定义为双眼视力低于 0.5（0.3 最小角分辨率对数的截距）。在 1324429.8 人年的随访期间，7852 名参与者新发双侧 VI。自我报告的当前吸烟状况与男性和女性发生 VI 的风险增加相关，女性的相关性更强（交互作用 P 值=0.01）。多变量调整后，与从不吸烟者相比，当前吸烟者发生 VI 的风险比（95%置信区间）为男性 1.14（1.04-1.25）和女性 1.52（1.28-1.80）。尿可替宁水平≥100ng/ml 与 VI 发病风险增加显著相关，并且当在随访期间引入尿可替宁和其他混杂因素的变化作为时变协变量时，这些关联仍然存在。基于自我报告和尿可替宁水平评估的吸烟与 VI 发病率增加有关。我们的研究结果表明，吸烟是 VI 的一个独立危险因素。
