美国成年人中与手术治疗白内障相关的全身用药评估。

Evaluation of Systemic Medications Associated With Surgically Treated Cataract Among US Adults.

作者信息

Deng Ruidong, Zhu Zhuoting, Han Xiaotong, Shang Xianwen, He Mingguang, Xu Guihua, Chen Zilin, Fan Huiya

机构信息

From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Z.Z., X.H., X.S., M.H.), Guangzhou, China; Ophthalmology, Department of Surgery, University of Melbourne (Z.Z., M.H.), Melbourne, Australia.

出版信息

Am J Ophthalmol. 2023 May;249:126-136. doi: 10.1016/j.ajo.2023.01.005. Epub 2023 Jan 14.

DOI:10.1016/j.ajo.2023.01.005

PMID:36646239

Abstract

PURPOSE

To comprehensively determine the associations between systemic medications and surgically treated cataract in the US population.

DESIGNS

Retrospective cross-sectional study.

METHODS

Participants aged ≥40 years from the 1999-2008 National Health and Nutrition Examination Survey (NHANES) were included. Surgically treated cataract was defined as cataract requiring a procedure. Data on prescription drug use over the past 30 days were collected via home interviews. Drug categories for ophthalmic indications and those prescribed in less than 0.5% of the participants were excluded from the analysis. Separate logistic regression models were used to explore associations between each drug category and surgically treated cataract. The Benjamin-Hochberg procedure was used to control the false discovery rate.

RESULTS

A total of 14,931 were included in the present analysis. The weighted prevalence of surgically treated cataract was 9.6% (n=2010). We identified 20 drug categories that had significant associations with surgically treated cataract, of which 8 associations remained statistically significant after further adjustment for pertinent comorbidities. The 3 drug categories with the highest odds ratio (OR) values were tricyclic antidepressants (OR, 2.21; 95% CI, 1.38-3.51; P = .001), insulin (OR, 2.13; 95% CI, 1.48-3.07; P = 9.41×10) and group III antiarrhythmic agents (OR, 2.00; 95% CI, 1.25-3.19; P = .004). The use of sex hormone combinations among women reduced the risk of having surgically treated cataract (OR, 0.011; 95% CI, 0.001-0.089; P = 5.98×10). Dose-response relationships were observed for all 8 drug categories.

CONCLUSIONS

Our comprehensive evaluation provides new knowledge on the complex relationships between systemic medications and surgically treated cataract.

摘要

目的

全面确定美国人群中全身用药与手术治疗白内障之间的关联。

设计

回顾性横断面研究。

方法

纳入1999 - 2008年美国国家健康与营养检查调查（NHANES）中年龄≥40岁的参与者。手术治疗的白内障定义为需要进行手术的白内障。通过家庭访谈收集过去30天内的处方药使用数据。眼科适应症药物类别以及使用参与者比例低于0.5%的药物类别被排除在分析之外。使用单独的逻辑回归模型来探索每种药物类别与手术治疗白内障之间的关联。采用本杰明 - 霍赫伯格程序控制错误发现率。

结果

本分析共纳入14931人。手术治疗白内障的加权患病率为9.6%（n = 2010）。我们确定了20种与手术治疗白内障有显著关联的药物类别，其中8种关联在进一步调整相关合并症后仍具有统计学意义。比值比（OR）值最高的3种药物类别是三环类抗抑郁药（OR，2.21；95%置信区间，1.38 - 3.51；P = 0.001）、胰岛素（OR，2.13；95%置信区间，1.48 - 3.07；P = 9.41×10）和Ⅲ类抗心律失常药（OR，2.00；95%置信区间，1.25 - 3.19；P = 0.004）。女性使用性激素组合可降低手术治疗白内障的风险（OR，0.011；95%置信区间，0.001 - 0.089；P = 5.98×10）。所有8种药物类别均观察到剂量 - 反应关系。