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年龄相关性黄斑变性与糖尿病风险之间的关联:一项全国性队列研究。

Association between Age-Related Macular Degeneration and the Risk of Diabetes Mellitus: A Nationwide Cohort Study.

作者信息

Jung Wonyoung, Yoon Je Moon, Han Kyungdo, Kim Bongseong, Hwang Sungsoon, Lim Dong Hui, Shin Dong Wook

机构信息

Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

Department of Medicine, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

出版信息

Biomedicines. 2022 Sep 29;10(10):2435. doi: 10.3390/biomedicines10102435.

Abstract

Age-related macular degeneration (AMD) is a degenerative and progressive disease of the macula, the part of the retina that is responsible for central vision. AMD shares some risk factors with diabetes mellitus (DM), but little is known about the risk of DM in individuals with AMD. With the goal of establishing novel perspectives, this study aimed to investigate the association between AMD and the risk of DM using the Korean Nationwide Health Insurance Database. Individuals aged ≥ 50 years who underwent a national health screening program in 2009 were enrolled. Participants were categorized by the presence of AMD and visual disability (VD). The Cox hazard regression model was used to examine hazard ratios (HRs) of DM with adjustment for potential confounders. Stratified analyses by age, sex, and comorbidities (hypertension or dyslipidemia) were also performed. During a mean follow-up of 8.61 years, there were 403,367 (11.76%) DM incidences among the final 3,430,532 participants. The crude HR (95% confidence interval (CI)) was 1.16 (1.13-1.20) for AMD. After adjusting for potential confounders, AMD was associated with a 3% decreased risk of DM (aHR 0.97, 95% CI 0.95-1.00), but no significant association with the risk of DM was found in AMD with VD (aHR 1.03, 95% CI 0.93-1.14). In summary, we did not find an increased risk of DM in individuals with AMD. A 3% decreased risk of DM in patients with AMD is not clinically meaningful. Our study suggests that the association between AMD and the risk of DM is weak, considering the potential confounders. Further studies examining this association are needed to extend our knowledge.

摘要

年龄相关性黄斑变性(AMD)是一种黄斑部的退行性和进行性疾病,黄斑是视网膜中负责中央视力的部分。AMD与糖尿病(DM)有一些共同的危险因素,但对于AMD患者患DM的风险知之甚少。为了建立新的观点,本研究旨在利用韩国全国健康保险数据库调查AMD与DM风险之间的关联。纳入了2009年参加全国健康筛查计划的年龄≥50岁的个体。参与者根据是否存在AMD和视力残疾(VD)进行分类。使用Cox风险回归模型来检验DM的风险比(HR),并对潜在混杂因素进行调整。还按年龄、性别和合并症(高血压或血脂异常)进行了分层分析。在平均8.61年的随访期间,最终的3430532名参与者中有403367例(11.76%)发生DM。AMD的粗HR(95%置信区间(CI))为1.16(1.13 - 1.20)。在对潜在混杂因素进行调整后,AMD与DM风险降低3%相关(校正后HR 0.97,95% CI 0.95 - 1.00),但在伴有VD的AMD患者中未发现与DM风险有显著关联(校正后HR 1.03,95% CI 0.93 - 1.14)。总之,我们未发现AMD患者患DM的风险增加。AMD患者DM风险降低3%在临床上无意义。考虑到潜在混杂因素,我们的研究表明AMD与DM风险之间的关联较弱。需要进一步研究来扩展我们对此关联的认识。

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