代谢综合征单一组分及多组分与ARC关系

Association of separate components of metabolic syndrome and their combinations with age-related cataract

目的探讨中老年人群代谢综合征及其组分和各组分联合作用与年龄相关白内障(ARC)的关系。方法采用1∶1匹配病例对照研究方法,对2010年12月—2011年12月接受手术治疗的360例病例组ARC患者和与病例同期入住相同医院、未患与白内障有关眼病的360例对照组患者进行问卷调查并对结果进行分析。结果病例组和对照组中糖尿病患者分别有104、55例,分别占28.89%和15.28%;高血压患者分别有131、96例,分别占36.39%和26.67%;高密度脂蛋白胆固醇(HDL-C)降低的分别有115、85例,分别占31.94%、23.61%,差异均有统计学意义(P<0.05);调整多种潜在性混杂因素后,糖尿病、高血压、HDL-C下降、甘油三酯(TG)升高、向心性肥胖均可使ARC发生的危险性增加;有代谢综合征者发生ARC的危险性是无代谢综合征者的2.213倍(OR=2.213,95%CI=1.012～4.837);具有≥3个代谢综合征组分的患者发生ARC的危险性明显升高(OR=2.667,95%CI=1.166～6.097);随着代谢综合征组分数量增加,发生ARC的危险性逐渐增高,线性趋势检验有统计学意义(χ2=10.326,P<0.001)。结论代谢综合征及其组分可使中老年人群发生ARC的危险性增加。

Objective To investigate associations of various components of metabolic syndrome and their combina- tions with the risk of age-related cataract （ARC） in middle-aged and elderly people. Methods A hospital-based case- control study was conducted. Cases（ n = 260）were patients of 45-85 years old with cataract and controls（ n = 260 ）were patients with diseases that not related to cataract and admitted to the same hospital with the cases. All subjects were inter- viewed with a structured interviewer-administrated questionnaire. The odds ratios（OR） and corresponding 95% confidence intervals（CI） of ARC were computed with multiple logistic regression model. Results After adjusting for multiple po- tential confounders, diabetes, hypertension, low high density lipoprotein, high triglyceride level, and central obesity were positively associated with ARC. Among the cases with metabolic syndrome, the risk of ARC was approximately 2-fold higher than that of the controls without metabolic syndrome （ OR = 2.213,95 % CI： 1.012 - 4. 837 ; P = 0. 023 ）. Cases with at least 3 components of the metabolic syndrome had a significantly increased risk of ARC（ OR = 2. 667,95% CI： 1. 166-6. 097;P =0. 014） compared with the controls without any of the components. The risk of ARC increased with the number of components of metabolic syndrome, and the linear trend test was statistically significant（X^2 = 10. 236, P 〈 0. 001 ）. Conclusion The study indicates that the metabolic syndrome,its components ,and their combination seem to be associated with an increased risk for ARC.