Smith W, Mitchell P, Leeder S R, Wang J J
National Centre for Epidemiology and Population Health, Australian National University, Sydney.
Arch Ophthalmol. 1998 May;116(5):583-7. doi: 10.1001/archopht.116.5.583.
To assess the relationship between stages of age-related maculopathy (ARM) and cardiovascular disease and cardiovascular disease risk factors, including serum lipid and plasma fibrinogen levels, smoking, cardiovascular events, systemic hypertension, diabetes mellitus, and obesity.
A cross-sectional study of 3654 subjects from a defined geographic area identified subjects with late age-related macular degeneration (ARMD) and early ARM from the masked grading of retinal photographs. The history, physical examination findings, and fasting blood samples provided data on possible risk factors. Logistic regression, adjusting for age, sex, and possible confounders, and 2-way analysis of variance were used to assess associations.
The only factors significantly associated with ARM included the 2 established risk factors, smoking and family history of ARMD (odds ratios, 4.1 and 4.2, for late ARMD, respectively), and the 2 variables, body mass index (odds ratio, 1.78 for obese compared with normal body mass index for early ARM) and plasma fibrinogen level (odds ratio, 6.7 for a fibrinogen level of >4.5 g/L [highest quartile] compared with a fibrinogen level of <3.4 g/L [lowest quartile] for late ARMD).
These findings support the concepts that associations exist between plasma fibrinogen levels and late ARMD, a body mass index outside the normal range, and early ARM, and between the family history and smoking and any ARM. We found no other significant associations with any history of cardiovascular disease or other risk factors for cardiovascular disease.
评估年龄相关性黄斑病变(ARM)分期与心血管疾病及心血管疾病危险因素之间的关系,这些危险因素包括血脂、血浆纤维蛋白原水平、吸烟、心血管事件、系统性高血压、糖尿病和肥胖。
一项横断面研究,对来自特定地理区域的3654名受试者进行视网膜照片的盲法分级,以确定晚期年龄相关性黄斑变性(ARMD)和早期ARM患者。病史、体格检查结果和空腹血样提供了有关可能危险因素的数据。采用logistic回归分析,并对年龄、性别和可能的混杂因素进行校正,同时采用双向方差分析来评估相关性。
与ARM显著相关的唯一因素包括两个已确定的危险因素,即吸烟和ARMD家族史(晚期ARMD的比值比分别为4.1和4.2),以及两个变量,即体重指数(早期ARM患者中,肥胖者与正常体重指数者相比,比值比为1.78)和血浆纤维蛋白原水平(晚期ARMD患者中,纤维蛋白原水平>4.5 g/L[最高四分位数]与<3.4 g/L[最低四分位数]相比,比值比为6.7)。
这些研究结果支持以下观点:血浆纤维蛋白原水平与晚期ARMD、超出正常范围的体重指数与早期ARM之间存在关联,ARMD家族史和吸烟与任何ARM之间也存在关联。我们未发现与任何心血管疾病病史或其他心血管疾病危险因素存在其他显著关联。