Yip Jennifer Lai Yee, Muthy Zaynah, Peto Tunde, Lotery Andrew, Foster Paul J, Patel Praveen
Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
Institute of Ophthalmology, UCL, London, UK.
BMJ Open Ophthalmol. 2021 Feb 23;6(1):e000585. doi: 10.1136/bmjophth-2020-000585. eCollection 2021.
There is contrasting evidence on the relationship between socioeconomic status (SES) and age-related macular degeneration (AMD), the most common cause of visual impairment (VI) in developed countries. This study examines the relationship between SES, cardiovascular risk factors and self-reported AMD.
Over 500000 people participated in the UK Biobank study from 2006 to 2019, with sociodemographic data and clinical measurements collected using standardised procedures. Visual acuity was measured in 117907 participants with VI defined as LogMAR ≤0.3. We used logistic regression to examine the cross-sectional associations between SES and self-reported AMD.
Self-reported AMD was available for 133339 participants aged 50 and older. People reporting AMD had higher academic qualifications, lower income, were unable to work due to disability, have higher BMI, diabetes and vascular heart disease after adjusting for age and sex. In a multivariable analysis, higher income was protective of AMD and economic inactivity due to disability increased the odds of AMD (2.02, 95% CI 1.13 to 3.61). Both associations were independent of cardiovascular factors, but was no longer significant after adjusting for VI.
The association between education, employment and household income with AMD was independent of cardiovascular risk factors.
社会经济地位（SES）与年龄相关性黄斑变性（AMD）之间的关系存在相互矛盾的证据，AMD是发达国家视力损害（VI）的最常见原因。本研究探讨SES、心血管危险因素与自我报告的AMD之间的关系。
2006年至2019年期间，超过50万人参与了英国生物银行研究，使用标准化程序收集了社会人口统计学数据和临床测量数据。对117907名参与者进行了视力测量，将视力损害定义为LogMAR≤0.3。我们使用逻辑回归来研究SES与自我报告的AMD之间的横断面关联。
133339名50岁及以上参与者提供了自我报告的AMD数据。在调整年龄和性别后，报告患有AMD的人学历较高、收入较低、因残疾无法工作、体重指数较高、患有糖尿病和心血管疾病。在多变量分析中，较高的收入对AMD有保护作用，因残疾导致的经济不活动增加了患AMD的几率（2.02，95%置信区间1.13至3.61）。这两种关联均独立于心血管因素，但在调整视力损害后不再显著。
教育、就业和家庭收入与AMD之间的关联独立于心血管危险因素。
