膳食宏量营养素摄入量与年龄相关白内障危险性分析

Association between Dietary Macronutrient Intake and Age-related Cataract

目的探讨中老年人膳食宏量摄入量与年龄相关白内障(ARC)危险性之间的关系。方法选取2009年9月—2011年3月45～85岁的白内障患者360例为病例组,对照组为同期入院的360例非白内障患者。采用标准调查表对研究对象进行调查,内容包括人口学特征、生活方式以及既往疾病史等,同时采用一份有效的半定量化食物频率调查表(FFQ),获取研究对象膳食营养素的摄入情况。应用多因素Logistic回归分析估计各种宏量营养素摄入量与3种类型白内障关联的比值比(OR)及其相应的95%可信区间(CI)。结果调整多种潜在性混杂因素后,总碳水化合物摄入量与皮质性白内障呈正相关,与摄入量为最低四分位数的患者相比,摄入量为最高四分位数的患者发生皮质性白内障的OR=2.471〔95%CI(1.348,6.043),P=0.027〕。蛋白质摄入量增加对后囊膜下白内障(PSC)具有预防作用〔OR=0.528,95%CI(0.148,0.869),P=0.023〕。总脂肪摄入量与任一类型白内障均无相关性,但多不饱和脂肪酸摄入量为最高四分位数者发生核性白内障的危险性是最低四分位数者的2.7倍〔OR=2.742,95%CI(1.790,4.200),P=0.033〕。结论大量摄入碳水化合物和多不饱和脂肪酸可分别使发生皮质性和核性白内障的危险性升高,而蛋白质,尤其是动物蛋白摄入量增加能够预防PSC,调整中老年人群膳食习惯可能有助于预防ARC。

Objective To examine the association between dietary macronutrient intake and age-related cataract（ARC） in middle-aged and elderly men.Methods A hospital-based case-control study was conducted from September 2009 to March 2011.The case group included 360 patients with cataract aged 45～85 years old,and the control group included 360 patients who had been admitted to the same hospital for diseases not related to cataract.All subjects were interviewed using a structured interviewer-administrated questionnaire that included information on socio-demographic characteristics,lifestyle habits,and detailed medical history.Meanwhile,the dietary intakes of nutrients were collected via a valid semi-quantitative food frequency questionnaire（FFQ）.The odds ratios（OR） and corresponding 95% confidence intervals（CI） of three types of ARC were obtained using multiple logistic regression models.Results After adjusting many multiple potential confounders,it was found that total dietary intake of carbohydrate was positively correlated to cortical cataract.Compared to controls in the lowest quartile,the OR for cases in the highest quartile intake was 2.471（95% CI（1.348,6.043）,P=0.027）.Higher dietary intakes of protein played a protective role in posterior subcapsular cataract（PSC）（OR =0.528,95% CI（0.148,0.869）,P=0.023）.Total dietary fat intake was not associated with any type of cataract;however,the amount of polyunsaturated fatty acids intake were closely related with cataract.The risk of the subjects who had the highest quartile intake was 2.7 times as high as that of those who had the lowest quartile intake（OR =2.742,95% CI（1.790,4.200）,P=0.033）.Conclusion A higher intake of carbohydrate and polyunsaturated fatty acid may increase the odds of cortical and nuclear cataract,respectively.However,high intake of protein（especially animal protein） may protect against PSC cataract.Dietary changes in the target populations may help to reduce the risk of ARC.