THE LENS OPACITIES CASE-CONTROL STUDY - RISK-FACTORS FOR CATARACT
THE LENS OPACITIES CASE-CONTROL STUDY - RISK-FACTORS FOR CATARACT
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DOI：
10.1001/archopht.1991.01080020090051
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发表时间：
1991-02-01
影响因子：
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通讯作者：
WU, SY
中科院分区：
文献类型：
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作者：
LESKE, MC;CHYLACK, LT;WU, SY
晶状体混浊的病例对照研究评估了与年龄相关的核性、皮质性、后囊膜下和混合性白内障的危险因素。1380名参与者为40 ~ 79岁的眼科门诊患者，分为以下组：仅后囊膜下组72例；仅核，137例；仅皮质290例；混合性白内障446例；对照组是435名患者。在多元logistic回归分析中，低教育程度增加了所有类型白内障的风险（比值比[OR] = 1.46），而经常使用多种维生素补充剂降低了风险（OR = 0.63）。饮食中摄入具有抗氧化潜力的核黄素、维生素C、维生素E和胡萝卜素对皮质性、核性和混合性白内障具有保护作用；摄入烟酸、硫胺素和铁也能降低风险。在综合抗氧化维生素（OR = 0.40）或考虑单个营养素（OR = 0.48至0.56）的分析中也发现了类似的结果。糖尿病增加后囊膜下、皮质性和混合性白内障的风险（OR = 1.56）。口服类固醇治疗增加后囊膜下白内障的风险（OR = 5.83）。女性（OR = 1.51）和非白人（OR = 2.03）只有皮质性白内障的风险增加。核性白内障的危险因素为非专业职业（OR = 1.96）、吸烟（OR = 1.68）、体重指数（OR = 0.76）和职业日照（OR = 0.61）。痛风药物（OR = 2.48）、家族史（OR = 1.52）和20岁前是否佩戴眼镜（OR = 1.44）增加了混合性白内障的发生风险。研究结果支持营养、医疗、个人和其他因素在白内障发生中的作用。本研究提出的潜在可改变因素值得进一步评估。
The Lens Opacities Case-Control Study evaluated risk factors for age-related nuclear, cortical, posterior subcapsular, and mixed cataracts. The 1380 participants were ophthalmology outpatients, aged 40 to 79 years, classified into the following groups: posterior subcapsular only, 72 patients; nuclear only, 137 patients; cortical only, 290 patients; mixed cataract, 446 patients; and controls, 435 patients. In polychotomous logistic regression analyses, low education increased risk (odds ratio [OR] = 1.46) and regular use of multivitamin supplements decreased risk (OR = 0.63) for all cataract types. Dietary intake of riboflavin, vitamins C, E, and carotene, which have antioxidant potential, was protective for cortical, nuclear, and mixed cataract; intake of niacin, thiamine, and iron also decreased risk. Similar results were found in analyses that combined the antioxidant vitamins (OR = 0.40) or considered the individual nutrients (OR = 0.48 to 0.56). Diabetes increased risk of posterior subcapsular, cortical, and mixed cataracts (OR = 1.56). Oral steroid therapy increased posterior subcapsular cataract risk (OR = 5.83). Females (OR = 1.51) and nonwhites (OR = 2.03) were at increased risk only for cortical cataract. Risk factors for nuclear cataract were a nonprofessional occupation (OR = 1.96), current smoking (OR = 1.68), body mass index (OR = 0.76), and occupational exposure to sunlight (OR = 0.61). Gout medications (OR = 2.48), family history (OR = 1.52), and use of eyeglasses by age 20 years, which is an indicator of myopia (OR = 1.44), increased risk of mixed cataract. The results support a role for the nutritional, medical, personal, and other factors in cataractogenesis. The potentially modifiable factors suggested by this study merit further evaluation.