基于韩国国民健康保险服务-健康筛查队列（NHIS-HEALS）数据的 50 岁及以上人群中脂肪肝指数与白内障手术发生率的相关性：纵向回顾性队列研究。

Association Between Fatty Liver Index and Incidence of Cataract Surgery in Individuals Aged 50 Years and Older Based on the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) Data: Longitudinal Retrospective Cohort Study.

机构信息

Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Republic of Korea.

Clinical Research Team Hyundai Pharm Co., Seoul, Republic of Korea.

出版信息

JMIR Public Health Surveill. 2024 Nov 14;10:e57168. doi: 10.2196/57168.

DOI:10.2196/57168

PMID:39541585

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11581417/

Abstract

BACKGROUND

Cataract is a leading cause of vision impairment. Obesity-related risk factors, including insulin resistance, increase the risk of cataract. The fatty liver index (FLI) is a biomarker for noninvasive fat layer prediction of nonalcoholic fatty liver disease. The FLI has been used to evaluate the metabolic contribution in other organs besides the eye. However, no study exists on the FLI and eye disease.

OBJECTIVE

This retrospective cohort study for the association between the FLI and incidence of cataract surgery in individuals older than 50 years was designed to show that a higher FLI is associated with an increased incidence of cataract surgery in individuals aged 50 years and older.

METHODS

This study was retrospectively designed based on the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) cohort (median follow-up of 9.8 years). Participants were assigned to 1 of 3 groups based on the FLI: low (FLI<30), intermediate (FLI 30-59), or high (FLI≥60). Kaplan-Meier survival analysis was performed on the cumulative incidence of all-cataract and senile-cataract surgery. Multivariable Cox proportional hazards regression models were used to study the association between the FLI group and cataract surgery after adjusting for potential confounders.

RESULTS

Of the 138,347 included participants, the incidence of cataract surgery was 12.49% (4779/38,274), 13.95% (6680/47,875), and 14.16% (7496/52,930) in the low, intermediate, and high FLI groups, respectively. After adjusting for all confounding factors, hazard ratios (HRs; 95% CIs) in the high FLI group for all-cataract surgery were 1.111 (1.028-1.199) and 1.184 (1.101-1.274) in men and women, respectively, when compared with the low FLI group. HRs (95% CIs) in the high FLI group for senile-cataract surgery were 1.106 (1.022-1.197) and 1.147 (1.065-1.237) in men and women, respectively, when compared with the low FLI group. The project was conducted between August 2023 and February 2024 without donations from external bodies.

CONCLUSIONS

Individuals with a higher FLI had a higher risk of all-cataract surgery. This association was maintained even after limiting the analyses to senile-cataract surgery.

摘要

背景

白内障是导致视力损害的主要原因之一。肥胖相关的危险因素，包括胰岛素抵抗，增加了白内障的风险。脂肪肝指数（FLI）是一种用于预测非酒精性脂肪性肝病无创性脂肪层的生物标志物。FLI 已被用于评估除眼睛以外其他器官的代谢贡献。然而，目前还没有关于 FLI 和眼部疾病的研究。

目的

本回顾性队列研究旨在探讨 50 岁以上人群 FLI 与白内障手术发生率之间的关系，以表明较高的 FLI 与 50 岁及以上人群白内障手术发生率的增加有关。

方法

本研究基于韩国国民健康保险服务-健康筛查队列（NHIS-HEALS）队列（中位随访时间为 9.8 年）进行回顾性设计。参与者根据 FLI 分为 3 组：低（FLI<30）、中（FLI 30-59）或高（FLI≥60）。对所有白内障和老年性白内障手术的累积发生率进行 Kaplan-Meier 生存分析。使用多变量 Cox 比例风险回归模型，在调整潜在混杂因素后，研究 FLI 组与白内障手术之间的关系。

结果

在纳入的 138347 名参与者中，低、中、高 FLI 组的白内障手术发生率分别为 12.49%（4779/38274）、13.95%（6680/47875）和 14.16%（7496/52930）。在调整所有混杂因素后，与低 FLI 组相比，男性和女性高 FLI 组的全白内障手术的危险比（HR；95%CI）分别为 1.111（1.028-1.199）和 1.184（1.101-1.274）。与低 FLI 组相比，男性和女性高 FLI 组老年性白内障手术的 HR（95%CI）分别为 1.106（1.022-1.197）和 1.147（1.065-1.237）。该项目于 2023 年 8 月至 2024 年 2 月进行，没有外部机构的捐赠。