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代谢状态的动态变化与眼运动颅神经麻痹的风险相关。

Dynamic Changes in Metabolic Status Are Associated With Risk of Ocular Motor Cranial Nerve Palsies.

机构信息

Department of Ophthalmology (DDC), Kim's Eye Hospital, Seoul, Korea; Department of Ophthalmology (K-APKH, SYO), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; and Department of Statistics (K-APKH), Soong Sil University, Seoul, Korea.

出版信息

J Neuroophthalmol. 2024 Sep 1;44(3):386-393. doi: 10.1097/WNO.0000000000001978. Epub 2023 Aug 31.

Abstract

BACKGROUND

To investigate whether recovery from or development of metabolic syndrome (MetS) in a population is associated with an altered risk for ocular motor cranial nerve palsy (CNP).

METHODS

This cohort study included 4,233,273 adults without a history of ocular motor cranial nerve palsy (ocular motor CNP) who underwent 2 consecutive biennial health screenings provided by the Korean National Health Insurance System between 2009 and 2011. They were followed up until December 31, 2018. Participants were categorized into a MetS-free, MetS-developed, MetS-recovered, or MetS-chronic group. A multivariable Cox proportional hazard regression model was used. Model 3 was adjusted for age, sex, smoking status, alcohol consumption, and physical activity.

RESULTS

Compared with the MetS-free group, the MetS-chronic group had the highest risk of ocular motor CNP (hazard ratio [HR]: 1.424; 95% confidential interval [CI]: 1.294-1.567, Model 3), followed by the MetS-developed group (HR: 1.198, 95% CI: 1.069-1.343), and the MetS-recovered group (HR: 1.168, 95% CI: 1.026-1.311) after adjusting for potential confounders. The hazard ratio of ocular motor CNP in men with chronic MetS was 1.566 (95% CI, 1.394-1.761) while that of women with chronic MetS was 1.191 (95% CI, 1.005-1.411). Among age groups, those in their 30s and 40s showed the highest association between dynamic MetS status and ocular motor CNP.

CONCLUSIONS

In our study, recovering from MetS was associated with a reduced risk of ocular motor CNP compared with chronic MetS, suggesting that ocular motor CNP risk could be managed by changing MetS status.

摘要

背景

本研究旨在探讨人群中代谢综合征(MetS)的恢复或发展是否与眼动颅神经麻痹(CNP)的风险改变相关。

方法

这是一项队列研究,共纳入 4233273 名无眼动颅神经麻痹(眼动 CNP)病史的成年人,他们在 2009 年至 2011 年期间接受了韩国国家健康保险系统提供的两次连续的两年一次健康筛查。随访至 2018 年 12 月 31 日。参与者被分为无 MetS、发生 MetS、恢复 MetS 和慢性 MetS 组。采用多变量 Cox 比例风险回归模型。模型 3 调整了年龄、性别、吸烟状况、饮酒和身体活动。

结果

与无 MetS 组相比,慢性 MetS 组发生眼动 CNP 的风险最高(风险比 [HR]:1.424;95%置信区间 [CI]:1.294-1.567,模型 3),其次是发生 MetS 组(HR:1.198,95% CI:1.069-1.343)和恢复 MetS 组(HR:1.168,95% CI:1.026-1.311),调整了潜在混杂因素后。男性慢性 MetS 患者眼动 CNP 的风险比为 1.566(95% CI,1.394-1.761),女性慢性 MetS 患者眼动 CNP 的风险比为 1.191(95% CI,1.005-1.411)。在年龄组中,30 多岁和 40 多岁的人群中动态 MetS 状态与眼动 CNP 的关联最高。

结论

在我们的研究中,与慢性 MetS 相比,MetS 的恢复与眼动 CNP 的风险降低相关,这表明通过改变 MetS 状态可以控制眼动 CNP 的风险。

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