老年人群白内障的影响因素分析

Factors affecting cataract among the elderly population

目的 了解老年人群白内障发病的影响因素,为白内障防治工作提供参考。方法 基于浙江省重大公共卫生监测项目,采用多阶段分层整群随机抽样法抽取浙江省7个县(区)≥60岁居民为调查对象,于2014—2020年每隔1年随访1次,收集人口学信息、生活行为方式、饮食和白内障发病资料;采用多因素Cox比例风险回归模型分析白内障发病的影响因素。结果 调查9 642人,年龄为(68.89±7.39)岁;男性4 635人,占48.07%。新发白内障828例,发病率为20.946/1 000人年。多因素Cox比例风险回归分析结果显示,女性(HR=1.695,95%CI:1.377~2.088)、≥65岁(HR:1.707~5.044,95%CI:1.400~7.327)、超重/肥胖(HR=1.313,95%CI:1.131~1.524)、文化程度(小学,HR=1.642,95%CI:1.400~1.926;初中,HR=1.553,95%CI:1.148~2.102)、家庭年收入(1万~<5万元,HR=1.353,95%CI:1.155~1.585;5万~<10万元,HR=0.663,95%CI:0.500~0.881;10万~<15万元,HR=0.340,95%CI:0.204~0.565)、吸烟(HR=0.649,95%CI:0.494~0.853)、蔬菜摄入频率>3 d/周(HR=0.693,95%CI:0.527~0.912)、水果摄入频率>3 d/周(HR=0.833,95%CI:0.694~0.899)、蛋类摄入频率>3 d/周(HR=0.579,95%CI:0.450~0.745)、豆制品摄入频率>3 d/周(HR=0.706,95%CI:0.588~0.849)、乳制品摄入频率>3 d/周(HR=1.510,95%CI:1.199~1.901)和坚果摄入频率>3 d/周(HR=1.733,95%CI:1.162~2.586)与老年人白内障发病有统计学关联。结论 性别,年龄,体质指数,文化程度,收入,吸烟,蔬菜、水果、蛋类、豆制品、乳制品和坚果摄入频率是老年人群白内障发病的影响因素。

Objective To investigate the factors affecting cataract among the elderly,so as to provide insights into cata⁃ract control.Methods Based on the major public health monitoring project of Zhejiang Province,residents at ages of 60 years and older were selected from 7 districts(counties)using a multi-stage stratified cluster random sampling meth⁃od,and were followed up every other year from 2014 to 2020.Demographics,lifestyle,dietary habits and cataract inci⁃dence were collected,and factors affecting the incidence of cataract were identified using a multivariable Cox proportion⁃al hazard regression model.Results Totally 9642 residents were investigated,with a mean age of(68.89±7.39)years,and including 4635 males(48.07%).There were 828 incident cataract cases,with an incidence rate of 20.946/1000 person-years.Multivariable Cox proportional hazard regression analysis showed that women(HR=1.695,95%CI:1.377-2.088),age of 65 years and older(HR=1.707-5.044,95%CI:1.400-7.327),overweight/obesity(HR=1.313,95%CI:1.131-1.524),educational level(primary school,HR=1.642,95%CI:1.400,1.926;junior high school,HR=1.553,95%CI:1.148-2.102),annual family income(10000 to 50000 Yuan,HR=1.353,95%CI:1.155-1.585;50000 to 100000 Yuan,HR=0.663,95%CI:0.500-0.881;100000 to 150000 Yuan,HR=0.340,95%CI:0.204-0.565),smoking(HR=0.649,95%CI:0.494-0.853),frequency of vegetable intake of>3 days/week(HR=0.693,95%CI:0.527-0.912),frequency of fruit intake f>3 days/week(HR=0.833,95%CI:0.694-0.899),frequency of egg intake of>3 days/week(HR=0.579,95%CI:0.450-0.745),frequency of soy products intake of>3 days/week(HR=0.706,95%CI:0.588-0.849),frequency of dairy products intake of>3 days/week(HR=1.510,95%CI:1.199-1.901)and frequency of nut intake of>3 days/week(HR=1.733,95%CI:1.162-2.586)were statistically associated with the development of cataract among the elderly.Conclu⁃sion Gender,age,body mass index,educational level,income,smoking,and frequency of vegetables,fruits,eggs,soy products,dairy products and nuts intake are associated with the development of cataracts.