高血压、体质指数与年龄相关白内障的关系研究

Correlation of Age-Related Cataract with Hypertension,Body Mass Index

目的探讨中老年人高血压、体质指数(BMI)与年龄相关白内障(ARC)危险性之间的关系。方法采用以医院为基础的病例对照研究方法。病例组由45～85岁的360例ARC患者组成,对照组由同期入住相同医院的360例非白内障患者组成,采取1:1匹配。采用标准调查表对研究对象进行面对面调查,内容包括人口学特征、生活方式以及疾病既往史等,同时对身高、体质量进行测量,计算BMI和腰臀比。应用多因素Logistic回归分析估计高血压及BMI与ARC关联的比值比(OR)及其相应的95%可信区间(CI)。结果在调整了年龄和性别因素后,高血压与ARC呈显著正相关(OR=1.573,P=0.005)。与收缩压正常者相比较,收缩压≥180 mm Hg者发病的危险性增加[OR=2.812,95%CI(1.450,5.455),P=0.002]。高血压病程10～20年的研究对象发病的危险性升高[OR=1.867,95%CI(1.053,3.307),P=0.033]。同样,与正常BMI者相比较,无论是超重或肥胖,发生ARC的危险性均显著升高[分别为:OR=1.587,95%CI(1.135,2.218),P=0.007;OR=2.315,95%CI(1.369,3.914),P=0.002]。BMI为24.0～27.9 kg/m2者患高血压可使发生ARC的危险性显著增加[OR=1.991,95%CI(1.160,3.419),P=0.012]。进一步控制多种混杂因素后的多因素分析结果并未发生改变。结论高血压、BMI增高可使发生ARC的危险性升高;均衡膳食、适量运动,维持正常血压和体质量可能有助于预防ARC。

Objective To investigate the association between hypertension,body mass index（BMI） and the risk of age-related cataract（ARC） in middle-aged and elderly people. Methods A hospital-based case control study was conducted.Disease group（n=360） was composed of ARC patients aged 45～85,and control group（n=360） was composed of non-ARC patients who had been admitted concurrently,with an 1：1 matching ratio.All subjects were interviewed by using a structured questionnaire,including information on socio-demographic characteristics,lifestyle habits and detailed medical history.Height and weight of them were measured,and BMI and waist-to-hip ratio（WHR） were calculated simultaneously.The odds ratios（OR） of correlation of ARC with hypertension and BMI,and 95% confidence intervals（CI） were estimated by using multiple Logistic regression analysis. Results After the adjustment of age and gender factors,hypertension was positively correlated with ARC（OR=1.573,P=0.005）.ARC odds was increased in patients whose systolic blood pressure ≥180 mm Hg as compared with those with normal blood pressure [OR=2.812,95%CI（1.450,5.455）,P=0.002].The ARC odds was associated with duration of hypertension,especially in patients with hypertension of 10～20 years[OR=1.867,95%CI（1.053,3.307）,P=0.033].Similarly,compared with subjects with normal BMI,both subjects whose BMI was above the standard and obesity subjects had higher ARC odds（24.0～27.9 or ≥28.0 kg/m2） and ARC[OR=1.587,95%CI（1.135,2.218）,P=0.007;OR=2.315,95% CI（1.369,3.914）,P=0.002 respectively].For subjects with higher BMI of（24.0～27.9 kg/m2） hypertension could significantly increase the ARC odds[OR=1.991,95% CI（1.160,3.419）,P=0.012].The results of multiple analyses were of no change after further control of several mixed factors. Conclusion Hypertension and higher BMI may increase the odds of ARC,so keeping healthy well-balanced diet and moderate exercise with maintenance of normal blood pressure and BMI can contribute to prevention of ARC.