From the Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China (C.C.X., Y.X.W., J.B.J.); Department of Ophthalmology, Peking University Third Hospital, Beijing, China (C.C.X., C.Z., H.L.D.).
Department of Physical Examination, Beijing Tongren Hospital, Capital Medical University, Beijing, China (J.C., D.N.C.).
Am J Ophthalmol. 2021 Jul;227:143-153. doi: 10.1016/j.ajo.2021.03.010. Epub 2021 Mar 15.
To assess potential associations between the prevalence of age-related macular degeneration (AMD) and systemic parameters in a Chinese population.
Cross-sectional study.
The Tongren Health Care Study included individuals attending regular health care check-up examinations in the Beijing Tongren Hospital from 2017 to 2019. Detailed medical examinations and ophthalmic examinations were applied, including fundus photography. AMD was evaluated according to the Beckman Initiative guidelines.
The study included 7,719 participants (mean age: 60.5 ± 8.1 years; range: 50-97 years). The prevalence of any, early, intermediate, and late AMD was 1,607 of 7,719 (20.8%; 95% confidence interval [CI]: 20.1%, 21.9%), 832 of 7,719 (10.8%; 95% CI: 10.1%, 11.5%), 733 of 7,719 (9.5%; 95% CI: 8.9%, 10.2%), and 42 of 7,719 (0.50%; 95% CI: 0.40%, 0.70%), respectively. In multivariate analysis, the prevalence of any AMD increased with higher blood monocyte count (odds ratio [OR]:3.49; 95% CI: 2.26, 5.38; P < .001), after adjusting for older age (OR: 1.06; 95% CI: 1.05, 1.07; P < .001), higher serum concentration of calcium (OR: 2.52; 95% CI: 1.32, 4.84; P = .005), high-density lipoproteins (OR: 1.39; 95% CI: 1.19, 1.61; P < .001), and lower lipoprotein a (OR: 0.99; 95% CI: 0.98, 0.99; P = .02). Similar findings were obtained for the prevalence of intermediate and late AMD combined. The association between higher monocyte count and higher AMD prevalence showed the highest odds ratio for the age group of 50-59 years (any AMD: OR: 4.35, P < .001; intermediate and late AMD: OR: 6.14, P < .001). Individuals with a monocyte count of ≥0.5 × 10/L as compared to participants with a monocyte of 0.1-0.4 × 10/L had a 1.45-fold increased risk for any AMD (OR: 1.45; 95% CI: 1.27, 1.64; P < .001) and 1.58 fold increase risk for intermediate/late AMD (OR: 1.58; 95% CI: 1.33, 1.87; P < .001).
A higher prevalence of early AMD, intermediate AMD, late AMD, and any AMD was associated with a higher peripheral monocyte count. In agreement with previous studies, the observation suggests monocytes playing a role in the pathogenesis of AMD.
评估在中国人群中年龄相关性黄斑变性（AMD）的患病率与全身参数之间的潜在关联。
横断面研究。
同仁卫生保健研究纳入了 2017 年至 2019 年期间在北京同仁医院定期进行健康检查的个体。进行了详细的医学检查和眼科检查，包括眼底摄影。根据贝克曼倡议指南评估 AMD。
该研究纳入了 7719 名参与者（平均年龄：60.5±8.1 岁；范围：50-97 岁）。任何、早期、中期和晚期 AMD 的患病率分别为 7719 名中的 1607 名（20.8%；95%置信区间[CI]：20.1%，21.9%）、832 名（10.8%；95% CI：10.1%，11.5%）、733 名（9.5%；95% CI：8.9%，10.2%）和 42 名（0.50%；95% CI：0.40%，0.70%）。多变量分析显示，任何 AMD 的患病率随着外周血单核细胞计数的升高而增加（优势比[OR]：3.49；95% CI：2.26，5.38；P<0.001），校正了年龄较大（OR：1.06；95% CI：1.05，1.07；P<0.001）、血清钙浓度较高（OR：2.52；95% CI：1.32，4.84；P=0.005）、高密度脂蛋白（OR：1.39；95% CI：1.19，1.61；P<0.001）和脂蛋白 a 较低（OR：0.99；95% CI：0.98，0.99；P=0.02）。同样的发现适用于中期和晚期 AMD 联合患病率。单核细胞计数升高与 AMD 患病率升高之间的关联在 50-59 岁年龄组中表现出最高的优势比（任何 AMD：OR：4.35，P<0.001；中期和晚期 AMD：OR：6.14，P<0.001）。与单核细胞为 0.1-0.4×10/L 的参与者相比，单核细胞计数≥0.5×10/L 的个体发生任何 AMD 的风险增加 1.45 倍（OR：1.45；95% CI：1.27，1.64；P<0.001），发生中间/晚期 AMD 的风险增加 1.58 倍（OR：1.58；95% CI：1.33，1.87；P<0.001）。
早期 AMD、中期 AMD、晚期 AMD 和任何 AMD 的患病率较高与外周血单核细胞计数较高有关。与先前的研究一致，这一观察结果表明单核细胞在 AMD 的发病机制中发挥作用。
