外周血血脂水平与老年性白内障相关性研究

Study on the correlation between peripheral blood lipid level and age-related cataract

目的探讨外周血血脂水平与年龄相关性白内障(age-related cataract,ARC)的相关性。方法采用回顾性病例对照设计,选取2018年1月—2019年12月于复旦大学附属眼耳鼻喉科医院就诊并确诊为ARC的患者280例作为观察组,其中男性140例,女性140例。同时选取同期217例正常健康体检者作为对照组,其中男性109例,女性108例。使用罗氏全自动生化分析仪检测受试者外周血胆固醇(cholesterol,CHOL)、三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high-densitylipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、载脂蛋白A(apolipoprotein A,Apo A)和载脂蛋白B(apolipoprotein B,Apo B)水平。采用独立样本t检验及二元多因素Logistic回归,分析上述血脂指标在观察组和对照组间的差异及其与ARC的相关性。结果观察组外周血CHOL、TG、HDL-C、LDL-C、ApoA、ApoB水平均高于对照组(P<0.05),并且在男性和女性亚组中均观察到相似的结果。Logistic回归分析显示,观察组CHOL(P=0.002,OR=1.467,95%CI=1.151~1.871)、TG(P<0.001,OR=3.400,95%CI=2.312~5.001)、HDL-C(P<0.001,OR=7.632,95%CI=3.8942~14.958)、LDL-C(P<0.001,OR=6.306,95%CI=4.440~9.011)、ApoB(P<0.001,OR=40.893,95%CI=16.003~104.493)、BMI(P<0.001,OR=1.256,95%CI=1.171~1.348)水平与ARC的发病存在一定相关性;与男性相比,外周血HDL-C(P<0.001,OR=9.180,95%CI=3.317~25.404)、LDL-C(P<0.001,OR=8.652,95%CI=4.965~15.077)和ApoB(P<0.001,OR=75.614,95%CI=19.448~293.990)水平较高的女性患ARC的风险更高。结论ARC患者外周血脂水平升高,CHOL、TG、HDL-C、LDL-C、ApoB升高可能增加中老年人群发生ARC的风险。

Objective To investigate the relationship between peripheral blood lipid levels and age-related cataract(ARC).Methods A retrospective case-control design was used.280 patients diagnosed as ARC in Ophthalmology and Otolaryngology Hospital Affiliated to Fudan University from January 2018 to December 2019 were selected as the observation group,including 140 males and 140 females.At the same time,217 normal healthy persons were selected as the control group,including 109 males and 108 females.The levels of peripheral blood cholesterol(CHOL),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and apolipoprotein A(ApoA)and apolipoprotein B(Apo B)were detected by Roche automatic biochemical analyzer.Independent sample T-test and binary multivariate logistic regression were used to analyze the differences of above blood lipid indexes between the two groups and their correlation with ARC.Results The levels of CHOL,TG,HDL-C,LDL-C,ApoA and ApoB in the observation group were higher than those in the control group(P<0.05),and similar results were observed in male and female subgroups.Logistic regression analysis showed that CHOL(P=0.002,OR=1.467,95%CI=1.151-1.871),TG(P<0.001,OR=3.400,95%CI=2.312-5.001),HDL-C(P<0.001,OR=7.632,95%CI=3.8942-14.958),LDL-C(P<0.001,OR=6.306,95%CI=4.440-9.011),ApoB(P<0.001,OR=40.893,95%CI=16.003-104.493)levels and BMI(P<0.001,OR=1.256,95%CI=1.171-1.348)were correlated with the incidence of ARC in the observation group.Compared with men,women with higher levels of HDL-C(P<0.001,OR=9.180,95%CI=3.317-25.404)、LDL-C(P<0.001,OR=8.652,95%CI=4.965-15.077)and ApoB(P<0.001,OR=75.614,95%CI=19.448-293.990)had higher risk of ARC.Conclusion ARC patients have elevated peripheral blood lipid levels.The increase of CHOL,TG,HDL-C,LDL-C and ApoB may increase the risk of ARC in middle-aged and elderly people.