人群研究载脂蛋白E基因与早期年龄相关性黄斑变性的相关性:动脉粥样硬化的发病风险

Objective: To examine the association between the apolipo-protein E (APOE) gene and early age-related maculopathy (ARM) in middle-aged persons. Design: Population-based cross-sectional study. Participants: Participants from the Atherosclerosis Risk in Communities Study (n=10 139; age range,49-73 years). Methods: Retinal photographywas performed on 1 randomly selected eye,and grading for presence of ARMwas carried out using a modification of the Wisconsin ARM Grading System. Early ARM was defined as the presence of either soft drusen alone,retinal pigment epithelial depigmentation alone,or a combination of soft drusen with increased retinal pigment and/or depigmentation. DNA extracted from blood samples of participants were analyzed for common allelic variants of the APOE gene ( 2, 3,and  4). Main Outcome Measures: Presence of early ARM on retinal photographs. Results: The prevalence of early ARM was similar in participants with differentAPOE genotypes:  2/ 2 (5.9% ), 2/ 3 (5.2% ), 2/ 4 (3.2% ), 3/ 3 (5.2% ), 3/ 4 (4.9% ),and  4/ 4 (4.1% ). After controlling for age,gender,race,cigarette smoking,and other factors,early ARM was not associated with APOE genotypes,with an odds ratio (OR) of 1.35 (95% confidence interval CI,0.54-3.38) for  2/ 2 genotype,an OR of 1.06 (95% CI,0.80-1.40) for  2/ 3 genotype,an OR of 0.63 (95% CI,0.32-1.24) for  2/ 4 genotype,an OR of 0.99 (95% CI,0.80-1.24) for  3/ 4 genotype,and an OR of 0.88 (95% CI,0.47-1.63) for  4/ 4 genotype,as compared with 3/3 genotype (reference). No associations were found for specific early ARM signs or in analyses stratified by age,gender,race,or cigarette smoking status. Conclusions: These data provide no evidence of a strong association between the APOE gene and early ARM in middle-aged persons. This suggests that APOE is not likely a major determinant of the early stages of ARM in younger people. However,our study does not exclude the possibility of a weaker association or that APOE may influence only the development of late ARM in older populations,as reported in other studies.

视网膜血管直径与高血压风险的前瞻性队列研究

Objective: To examine the relation between diameters of the re tinal arterioles and 10 year incidence of hypertension.Design: Population based prospective coho rt study. Setting: Beaver Dam eye study. Participants: 2451 normotensive people aged 43 to 84 years. Main outcome measures: Diameters of retinal arterioles and venules measured from digitised photographs of the retina taken at baseline. Mea surements summarised as the arteriole: venule ratio, with a lower ratio indicati ng smaller arteriolar diameters. Incident hypertension, defined as systolic bloo d pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihyper tensive drugs during follow up. Results: 721 participants developed hypertension over a 10 year period. Those with lower arteriole: venule ratios had a higher c umulative incidence of hypertension (incidences of 17.4%, 24.1%, 31.0%, and 4 5.1%, respectively, for decreasing quarters of distribution of arteriole:venule ratio). After adjustment for age and sex, participants with arteriole:venule ra tios in the lowest quarter had a threefold higher risk of hypertension (odds rat io 2.95, 95%confidence interval 2.77 to 3.88) than those with ratios in the hig hest quarter. This association remained significant after further adjustment for baseline systolic and diastolic blood pressure and other risk factors (1.82, 1. 39 to 2.40, for lowest versus highest ratio quarters). Conclusions: Narrowed ret inal arterioles are associated with long term risk of hypertension, suggesting t hat structural alterations of the microvasculature may be linked to the developm ent of hypertension.

视网膜动脉直径和高血压发生危险相关性的前瞻性队列研究

Obsjective: To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. Design: Population based prospective cohort study. Setting: Beaver Dam eye study. Participants: 2451 normotensive people aged 43 to 84 years. Main outcome measures: Diameters of retinal arterioles and venules measured from digitised photographs of the retina taken at baseline. Measurements summarised as the arteriole: venule ratio, with a lower ratio indicating smaller arteriolar diameters. Incident hypertension, defined as systolic blood pressure≥ 140 mm Hg, diastolic blood pressure≥ 90 mm Hg, or use of antihypertensive drugs during follow up. Results: 721 participants developed hypertension over a 10 year period. Those with lower arteriole: venule ratios had a higher cumulative incidence of hypertension (incidences of 17.4% , 24.1% , 31.0% , and 45.1% , respectively, for decreasing quarters of distribution of arteriole:venule ratio). After adjustment for age and sex, participants with arteriole:venule ratios in the lowest quarter had a threefold higher risk of hypertension (odds ratio 2.95, 95% confidence interval 2.77 to 3.88) than those with ratios in the highest quarter. This association remained significant after further adjustment for baseline systolic and diastolic blood pressure and other risk factors (1.82, 1.39 to 2.40, for lowest versus highest ratio quarters). Conclusions: Narrowed retinal arterioles are associated with long term risk of hypertension, suggesting that structural alterations of the microvasculature may be linked to the development of hypertension.

美国成人中血清尿酸与高血压前期的关系

背景:实验证据支持血清尿酸对高血压的发生具有致病效应。先前的流行病学研究已证实尿酸与高血压有关,但来自非高加索种族的资料有限。目前鲜有资料涉及血清尿酸水平与疾病谱中较早的临床相关血压(BP)分类之间的关系,在此时可应用高血压预防措施。