School of Nursing, China Medical University, Taichung 406040, Taiwan.
Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan.
Int J Environ Res Public Health. 2021 Dec 28;19(1):305. doi: 10.3390/ijerph19010305.
This retrospective cohort study was conducted to determine the glaucoma risk associated with metabolic disease (MetD) using insurance claims data of Taiwan.
From the database, we identified patients with newly diagnosed hypertension, diabetes and/or hyperlipidemia from the years 2000 to 2002 as the MetD cohort (N = 42,036) and an age-gender-diagnosis-date matched control cohort without MetD with a two-fold sample size than that of the MetD cohort. Both cohorts were followed until the development of glaucoma, death, or withdrawal, until 31 December 2013. The incidence of glaucoma, and the Cox method estimated hazard ratio (HR) of glaucoma were calculated. Results showed that the incidence of glaucoma was two-fold higher in the MetD cohort than in the controls (1.99 versus 0.99 per 1000 person-years), with an adjusted HR of 1.66 (95% CI: 1.50-1.85). The glaucoma incidence was higher in patients with diabetes than those with hypertension and hyperlipidemia (2.38 versus 1.95 and 1.72 per 1000 person-years, respectively). The incidence increased to 5.67 per 1000 person-years in patients with all three comorbidities, with an aHR of 4.95 (95% CI: 2.35-10.40). We also found higher incidence rates of primary open-angle glaucoma and primary angle-closure glaucoma with aHRs of 2.03 and 1.44, respectively. It was concluded that glaucoma risk increased with the number of MetD. Health providers need to monitor patients with MetD to prevent glaucoma.
本回顾性队列研究旨在利用台湾的医疗保险理赔数据，确定代谢疾病（MetD）与青光眼风险之间的关联。
我们从数据库中确定了 2000 年至 2002 年期间新诊断患有高血压、糖尿病和/或高脂血症的患者作为 MetD 队列（N=42036），并按照年龄、性别和诊断日期与 MetD 队列两倍大小的比例匹配无 MetD 的对照组。两个队列均随访至发生青光眼、死亡或退出，截止日期为 2013 年 12 月 31 日。计算了青光眼的发病率和 Cox 方法估计的青光眼风险比（HR）。结果表明，MetD 队列的青光眼发病率是对照组的两倍（每 1000 人年 1.99 比 0.99），调整后的 HR 为 1.66（95%CI：1.50-1.85）。患有糖尿病的患者比患有高血压和高脂血症的患者青光眼发病率更高（每 1000 人年分别为 2.38、1.95 和 1.72）。患有三种合并症的患者发病率上升至每 1000 人年 5.67，调整后的 HR 为 4.95（95%CI：2.35-10.40）。我们还发现原发性开角型青光眼和原发性闭角型青光眼的发病率更高，调整后的 HR 分别为 2.03 和 1.44。结论：青光眼风险随 MetD 的数量增加而增加。医疗服务提供者需要监测患有 MetD 的患者，以预防青光眼。
