Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
National Clinical Research Center for Eye Diseases, Shanghai, China.
Epidemiol Health. 2023;45:e2023034. doi: 10.4178/epih.e2023034. Epub 2023 Mar 9.
This study evaluated the association between obesity and glaucoma in middle-aged and older people. A population-based retrospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study.
Glaucoma was assessed via self-reports. Multivariate logistic regression analysis and a Cox proportional hazards model were used to assess the relationship between obesity and glaucoma risk.
Older males living in urban areas who were single, smokers, and non-drinkers were found to have a significantly higher incidence of glaucoma (all p<0.05). Diabetes, hypertension, and kidney disease were also associated with higher glaucoma risk, while dyslipidemia was associated with lower risk (all p<0.05). After the model was adjusted for demographic, socioeconomic, and health-related variables, obesity was significantly associated with a 10.2% decrease in glaucoma risk according to the Cox proportional hazards model (hazard ratio, 0.90; 95% confidence interval [CI], 0.83 to 0.97) and an 11.8% risk reduction in the multivariate logistic regression analysis (odds ratio, 0.88; 95% CI, 0.80 to 0.97). A further subgroup analysis showed that obesity was associated with a reduced risk of glaucoma in people living in rural areas, in smokers, and in those with kidney disease (all p<0.05). Obesity also reduced glaucoma risk in people with diabetes, hypertension, or dyslipidemia more than in healthy controls (all p<0.05).
This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease. Obesity exerted a stronger protective effect in people with diabetes, hypertension, or dyslipidemia than in healthy people.
本研究评估了中年和老年人肥胖与青光眼之间的关系。采用中国健康与退休纵向研究的数据进行了一项基于人群的回顾性队列研究。
通过自我报告评估青光眼。采用多变量逻辑回归分析和 Cox 比例风险模型评估肥胖与青光眼风险之间的关系。
居住在城市地区的单身、吸烟和不饮酒的老年男性患青光眼的发病率显著较高(均 p<0.05)。糖尿病、高血压和肾病也与较高的青光眼风险相关,而血脂异常与较低的风险相关(均 p<0.05)。在调整了人口统计学、社会经济和健康相关变量的模型中,Cox 比例风险模型显示肥胖与青光眼风险降低 10.2%显著相关(风险比,0.90;95%置信区间 [CI],0.83 至 0.97),多变量逻辑回归分析显示肥胖与青光眼风险降低 11.8%显著相关(比值比,0.88;95%CI,0.80 至 0.97)。进一步的亚组分析显示,肥胖与农村居民、吸烟者和肾病患者的青光眼风险降低相关(均 p<0.05)。肥胖还降低了糖尿病、高血压或血脂异常患者的青光眼风险,超过了健康对照组(均 p<0.05)。
本队列研究表明,肥胖与青光眼风险降低相关,尤其是在农村居民、吸烟者和肾病患者中。肥胖在糖尿病、高血压或血脂异常患者中比在健康人群中具有更强的保护作用。