Jian Linge, Huang Zhiqian, Du Yu, Zhu Xiangjia
Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.
NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China.
J Clin Med. 2025 Aug 19;14(16):5860. doi: 10.3390/jcm14165860.
: Although high myopia primarily affects the eyes, emerging evidence suggests that it is also associated with systemic inflammation and metabolic dysfunction. The liver plays a key role in metabolism and inflammation, and it may share pathological pathways with high myopia. However, no population studies have examined the relationship between high myopia and liver disease progression. This study used UK Biobank data to analyze the relationship between myopia severity and severe liver disease, as well as to determine whether inflammatory markers or metabolites mediate this link. : A prospective cohort of 70,774 UK Biobank participants without severe liver disease at baseline was followed for 14.1 years. Myopia was categorized as emmetropia, low-to-moderate, or high based on refractive error. Cox proportional hazards models, stratified by aspartate aminotransferase (AST) level (≥40 vs. <40 U/L), were used to assess liver disease risk, and mediation analyses were used to evaluate inflammatory markers and metabolites. : Among participants with AST levels of at least 40 U/L, high myopia significantly increased liver fibrosis and cirrhosis risk (hazard ratio [HR] = 2.64, 95% confidence interval [CI] = 1.44-4.85, = 0.002), exhibiting a dose-dependent trend (trend = 0.004). No association existed for AST < 40 U/L. C-reactive protein (CRP) partially mediated this link; no metabolites survived correction. : High myopia is independently associated with an increased risk of liver fibrosis and cirrhosis in individuals with elevated AST, partially mediated by CRP-related inflammation. Refractive assessment may stratify liver disease risk in subclinical injury, warranting anti-inflammatory intervention research.
虽然高度近视主要影响眼睛，但新出现的证据表明，它还与全身炎症和代谢功能障碍有关。肝脏在代谢和炎症中起关键作用，可能与高度近视有共同的病理途径。然而，尚无人群研究考察高度近视与肝脏疾病进展之间的关系。本研究利用英国生物银行的数据，分析近视严重程度与严重肝脏疾病之间的关系，并确定炎症标志物或代谢物是否介导了这种联系。：对70774名基线时无严重肝脏疾病的英国生物银行参与者进行了为期14.1年的前瞻性队列研究。根据屈光不正将近视分为正视、低度至中度或高度。采用按天冬氨酸转氨酶（AST）水平（≥40 vs.<40 U/L）分层的Cox比例风险模型评估肝脏疾病风险，并采用中介分析评估炎症标志物和代谢物。：在AST水平至少为40 U/L的参与者中，高度近视显著增加了肝纤维化和肝硬化风险（风险比[HR]=2.64，95%置信区间[CI]=1.44-4.85，=0.002），呈现剂量依赖性趋势（趋势=0.004）。对于AST<40 U/L者，不存在关联。C反应蛋白（CRP）部分介导了这种联系；校正后没有代谢物留存。：高度近视与AST升高个体的肝纤维化和肝硬化风险增加独立相关，部分由CRP相关炎症介导。屈光评估可能对亚临床损伤中的肝脏疾病风险进行分层，值得开展抗炎干预研究。
