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年龄相关性黄斑变性与既往甲状腺功能亢进和甲状腺功能减退的关联:一项病例对照研究。

Association of Age-Related Macular Degeneration with Prior Hyperthyroidism and Hypothyroidism: A Case-Control Study.

作者信息

Hung Shih-Han, Xirasagar Sudha, Kuang Tung-Mei Tammy, Chang Wei-Wen, Cheng Yen-Fu, Kuo Nai-Wen, Lin Herng-Ching

机构信息

Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.

Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan.

出版信息

J Pers Med. 2022 Apr 8;12(4):602. doi: 10.3390/jpm12040602.

Abstract

Prior studies suggest a possible association between thyroid disease and the subsequent development of age-related macular degeneration (AMD), although it remains inconclusive. This study aimed to evaluate the association of AMD with prior hyper-/hypothyroidism based on nationwide population-based data. We retrieved records of the study patients from the National Health Insurance Research Database, 7522 patients with a first-time diagnosis of AMD and 7522 propensity score-matched controls. Multiple logistic regression analyses were performed to explore the association of neovascular AMD with previously diagnosed hyperthyroidism or hypothyroidism. The Chi-square test shows that there was a statistically significant difference in the prevalence of prior hyperthyroidism between cases and controls (1.18 vs. 0.13%, p < 0.001). Furthermore, there was a statistically significant difference the prevalence of prior hypothyroidism between cases and controls (0.44 vs. 0.69%, p < 0.001). Multiple logistic regression analysis reveals that AMD was statistically and significantly associated with prior hyperthyroidism after adjusting for age, sex, monthly income, geographical location, urbanization level, hypertension, hyperlipidemia, diabetes, and coronary heart disease (odds ratio (OR) = 9.074, 95% CI = 4.713−17.471). The adjusted OR of prior hypothyroidism in patients with AMD was 3.794 (95% CI: 2.099~6.858) when compared to the controls. We conclude that patients with thyroid dysfunction are at higher risk of developing AMD Results suggest that these patients could benefit from proactive regular eye checkups to detect evolving eye pathology, even while vision remains normal during the initial phases.

摘要

先前的研究表明甲状腺疾病与年龄相关性黄斑变性(AMD)的后续发展之间可能存在关联,尽管这一点仍无定论。本研究旨在基于全国性的人群数据评估AMD与既往甲状腺功能亢进/减退之间的关联。我们从国民健康保险研究数据库中检索了研究患者的记录,7522例首次诊断为AMD的患者以及7522例倾向评分匹配的对照。进行了多项逻辑回归分析以探讨新生血管性AMD与先前诊断的甲状腺功能亢进或减退之间的关联。卡方检验表明,病例组和对照组中既往甲状腺功能亢进的患病率存在统计学上的显著差异(1.18%对0.13%,p<0.001)。此外,病例组和对照组中既往甲状腺功能减退的患病率也存在统计学上的显著差异(0.44%对0.69%,p<0.001)。多项逻辑回归分析显示,在调整年龄、性别、月收入、地理位置、城市化水平、高血压、高脂血症、糖尿病和冠心病后,AMD与既往甲状腺功能亢进在统计学上显著相关(优势比(OR)=9.074,95%置信区间=4.713−17.471)。与对照组相比,AMD患者既往甲状腺功能减退的调整后OR为3.794(95%置信区间:2.099~6.858)。我们得出结论,甲状腺功能障碍患者发生AMD的风险更高。结果表明,这些患者即使在初始阶段视力仍正常时,也可从积极定期的眼部检查中受益,以检测眼部病变的进展。

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