Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
School of Medicine South China University of Technology, Guangzhou, China.
Transl Vis Sci Technol. 2024 Nov 4;13(11):21. doi: 10.1167/tvst.13.11.21.
Cataract remains the primary cause of blindness in middle-income and low-income countries, with a known association with environmental factors including smoking. However, the relationship between early-life tobacco smoke exposures, including in utero tobacco smoke exposure and early initiation of smoking, and the risk of cataract incidence remains unclear. We aimed to examine the associations of early-life exposure to tobacco smoke with the risk of elderly-onset cataract.
In this prospective study, we included 330,528 participants aged 40 years or older who were recruited between 2006 and 2010. Early-life tobacco smoke exposures, including in utero, childhood, and adolescence exposure to tobacco smoke, as well as the type of tobacco smoke, were ascertained based on questionnaires at baseline. Elderly-onset cataract was ascertained using hospital inpatient records and cataract surgery records. Multivariable-adjusted Cox proportional hazards models were used to examine the association between early-life tobacco smoke exposures and incident cataract. Additionally, the association between different types of tobacco smoke and cataract risk was also explored.
During a median follow-up of 12.04 years, 14,754 cases of incident cataract were documented. After adjusting confounders, the incidence of cataract significantly increased among participants with tobacco smoke exposures (hazard ratio [HR] = 1.13, 95% confidence interval [CI] = 1.09-1.18). Furthermore, individuals who were exposed to tobacco smoke in childhood (HR = 1.10, 95% CI = 1.03-1.21), adolescence (HR = 1.15, 95% CI = 1.10-1.21), and adulthood (HR = 1.12, 95% CI = 1.05-1.19) had an increased risk of cataract. Additionally, individuals who smoked cigars or pipes (HR = 1.26, 95% CI = 1.11-1.44), hand-rolled cigarettes (HR = 1.20, 95% CI = 1.05-1.36), and manufactured cigarettes (HR = 1.12, 95% CI = 1.08-1.17) were associated with an increased risk of cataract.
Individuals with early-life tobacco smoke exposures in childhood and adolescence significantly elevate the risks of cataract incidence in older age.
This study identified cataract-associated risks and suggested interventions like banning youth smoking to reduce future cataract incidence.
白内障仍然是中低收入国家失明的主要原因，已知与包括吸烟在内的环境因素有关。然而，儿童期烟草烟雾暴露（包括宫内烟草烟雾暴露和早期开始吸烟）与白内障发病风险之间的关系尚不清楚。我们旨在研究儿童期暴露于烟草烟雾与老年发病白内障风险之间的关系。
在这项前瞻性研究中，我们纳入了 330528 名年龄在 40 岁或以上的参与者，他们于 2006 年至 2010 年间招募。基于基线时的问卷调查，确定了儿童期、青春期和儿童期的早期烟草烟雾暴露情况，包括宫内、儿童期和青春期接触烟草烟雾的情况，以及烟草烟雾的类型。使用医院住院记录和白内障手术记录确定老年发病白内障。使用多变量调整的 Cox 比例风险模型来研究早期烟草烟雾暴露与白内障发病之间的关联。此外，还探讨了不同类型的烟草烟雾与白内障风险之间的关系。
在中位随访 12.04 年期间，记录了 14754 例白内障发病。在调整混杂因素后，暴露于烟草烟雾的参与者白内障发病的发生率显著增加（风险比[HR] = 1.13，95%置信区间[CI] = 1.09-1.18）。此外，在儿童期（HR = 1.10，95%CI = 1.03-1.21）、青春期（HR = 1.15，95%CI = 1.10-1.21）和成年期（HR = 1.12，95%CI = 1.05-1.19）暴露于烟草烟雾的个体发生白内障的风险增加。此外，吸雪茄或烟斗（HR = 1.26，95%CI = 1.11-1.44）、手工卷烟（HR = 1.20，95%CI = 1.05-1.36）和机制卷烟（HR = 1.12，95%CI = 1.08-1.17）的个体发生白内障的风险也增加。
儿童期和青春期的早期烟草烟雾暴露会显著增加老年发病白内障的风险。
这项研究确定了与白内障相关的风险，并提出了干预措施，如禁止青少年吸烟，以降低未来白内障的发病率。
