Cumming R G, Mitchell P
Department of Public Health and Community Medicine, University of Sydney, Australia.
Ophthalmology. 1998 Sep;105(9):1751-8. doi: 10.1016/S0161-6420(98)99049-2.
Corticosteroids are known to cause cataracts, but the effects of other medications on the lens are unclear. The aim of this study was to investigate the relationships between cataracts and a range of medications, including allopurinol, aspirin, chloroquine, diuretics, phenothiazines, and simvastatin.
Population-based cross-sectional study.
3654 individuals 49 to 97 years of age (response rate, 82%) from an urban community near Sydney, Australia, were included.
Lens photography.
Lens photographs were graded for the presence and severity of cortical, nuclear, and posterior subcapsular cataract.
After adjusting for numerous potential confounders in ordinal regression models, use of phenothiazines was associated with nuclear cataract (adjusted odds ratio [OR], 2.18; 95% confidence interval [CI], 1.01-4.74); long-term aspirin users (> or = 10 years) had higher prevalence of posterior subcapsular cataract than did nonusers and short-term users (test for trend, P = 0.02); and the antimalarial drug mepacrine was associated with posterior subcapsular cataract (adjusted OR, 3.56; 95% CI, 1.56-8.13). There was a suggestion that use of chloroquine-like drugs for more than 1 year (test for trend, P = 0.12) might also be associated with posterior subcapsular cataract. Antihypertensive medications, cholesterol-lowering drugs, and allopurinol were not associated with any type of cataract. Potassium-sparing diuretics were the only diuretic to show any evidence of an association with cataract (test for trend for posterior subcapsular cataract, P = 0.14). Amiodarone was associated with cortical cataract (age- and gender-adjusted OR, 3.84; 95% CI, 1.01-14.81), but there were too few users to do analyses adjusted for multiple confounders.
Most drugs commonly used in the community do not appear to be associated with cataract. The findings of this study do not support the hypothesis that aspirin protects against cataract.
已知皮质类固醇会导致白内障，但其他药物对晶状体的影响尚不清楚。本研究的目的是调查白内障与一系列药物之间的关系，这些药物包括别嘌醇、阿司匹林、氯喹、利尿剂、吩噻嗪类药物和辛伐他汀。
基于人群的横断面研究。
纳入了来自澳大利亚悉尼附近一个城市社区的3654名年龄在49至97岁之间的个体（应答率为82%）。
晶状体摄影。
对晶状体照片进行分级，以确定皮质性、核性和后囊下白内障的存在及严重程度。
在有序回归模型中对众多潜在混杂因素进行校正后，使用吩噻嗪类药物与核性白内障相关（校正比值比[OR]为2.18；95%置信区间[CI]为1.01 - 4.7）；长期服用阿司匹林（≥10年）的人群后囊下白内障的患病率高于未使用者和短期使用者（趋势检验，P = 0.02）；抗疟药米帕林与后囊下白内障相关（校正OR为3.56；95%CI为1.56 - 8.13）。有迹象表明，使用氯喹类药物超过1年（趋势检验，P = 0.12）也可能与后囊下白内障相关。抗高血压药物、降胆固醇药物和别嘌醇与任何类型的白内障均无关联。保钾利尿剂是唯一显示出与白内障有任何关联证据的利尿剂（后囊下白内障趋势检验，P = 0.14）。胺碘酮与皮质性白内障相关（年龄和性别校正后的OR为3.84；95%CI为1.01 - 14.81），但使用者数量过少，无法进行针对多个混杂因素校正的分析。
社区中常用的大多数药物似乎与白内障无关。本研究结果不支持阿司匹林预防白内障的假说。
