Smoking and its association with cataract: Results of the Andhra Pradesh eye disease study from India
Smoking and its association with cataract: Results of the Andhra Pradesh eye disease study from India
复制标题
DOI：
10.1167/iovs.04-0089
复制
发表时间：
2005-01-01
影响因子：
4.4
通讯作者：
Balasubramanian, D
中科院分区：
文献类型：
--
作者：
Krishnaiah, S;Vilas, K;Balasubramanian, D
目的。目的探讨吸烟与不同类型白内障之间的关系。方法：在印度南部安得拉邦(AP)进行了一项以人群为基础的横断面流行病学研究。访问了来自1个城市和3个农村地区的10,293名具有AP人口代表性的各年龄段的受试者，每个人都接受了由训练有素的专业人员进行详细的扩眼评估。对7416名(72%)年龄在15岁的受试者的数据进行了分析。结果：年龄的增长与所有白内障类型、既往白内障手术史和/或全部白内障显著相关。在多因素分析中，在调整了所有人口统计因素和吸烟史后，女性、文盲和社会经济地位极低组的白内障患病率显著增加，调整后的优势比(OR)分别为1.60(95%可信区间：1.24-1.96)、1.46(95%可信区间：1.17-1.70)和1.92(95%可信区间：1.14-3.24)。调整后，吸烟和雪茄吸烟者的白内障患病率显著高于从不吸烟者，调整后OR分别为1.51(95%CI：1.10~2.06)和1.44(95%CI：1.12~1.84)。在吸烟者中，发现核性、皮质性白内障、既往白内障手术史和/或全发性白内障的患病率显著较高。吸烟和抽雪茄存在剂量-反应关系。校正后，与不吸烟者相比，重度吸烟者(吸烟14“包年”)患核性白内障(OR=1.65；95%CI：1.10~2.59)、皮质性白内障(OR=2.11；95%CI：1.38~3.24)、既往白内障手术史和/或全性白内障(OR=2.10；95%CI：1.05~4.22)的患病率显著升高。与从不吸烟的人相比，抽雪茄的人(调整后的OR=1.55；95%CI：1.16-2.01)和大量吸烟的雪茄吸烟者(吸烟21人年；OR=1.50；95%CI：1.10-1.95)的核性白内障显著增加。结论：与其他研究一致，吸烟与该人群中核性和皮质性白内障的患病率以及既往白内障手术史密切相关。这些发现表明，还有另一种需要教育社区，让他们了解戒烟的重要性，或许还需要将反吸烟的信息纳入学校健康计划。
PURPOSE. To investigate the associations between tobacco smoking and various forms of cataracts among the people of a state in India.METHODS. A population-based cross-sectional epidemiologic study was conducted in the south Indian state of Andhra Pradesh (AP). A total of 10,293 subjects of all ages from one urban and three rural areas, representative of the population of AP, were interviewed, and each underwent a detailed dilated ocular evaluation by trained professionals. Data were analyzed for 7416 (72%) of the subjects aged > 15 years.RESULTS. Increasing age was significantly associated with all cataract types and history of prior cataract surgery and/or total cataract. In multivariate analyses, after adjusting for all demographic factors and for history of smoking, females, illiterate persons, and those belonging to the extreme lower socioeconomic status group were found to have a significantly higher prevalence of any cataract, adjusted odds ratio ( OR) = 1.60 (95% confidence interval [CI]: 1.24 - 1.96), 1.46 ( 95% CI: 1.17 - 1.70), and 1.92 (95% CI: 1.14 - 3.24), respectively. After adjustment, cigarette and cigar smokers had a significantly higher prevalence of any cataract, adjusted OR = 1.51 ( 95% CI: 1.10 - 2.06) and 1.44 ( 95% CI: 1.12 - 1.84), respectively, compared with those who had never smoked ("never-smokers"). A significantly higher prevalence of nuclear, cortical cataract, and history of prior cataract surgery and/or total cataract was found among cigarette smokers. A dose - response relationship was seen with respect to cigarette and cigar smoking. After adjustment, compared with never-smokers, cigarette smokers who smoked heavily ( > 14 "pack-years" of smoking) had a significantly higher prevalence of nuclear cataract ( OR = 1.65; 95% CI: 1.10 - 2.59), cortical cataract ( OR = 2.11; 95% CI: 1.38 - 3.24), and history of prior cataract surgery and/or total cataract ( OR = 2.10; 95% CI: 1.05 - 4.22). Nuclear cataract was significantly higher in cigar smokers ( adjusted OR = 1.55; 95% CI: 1.16 - 2.01) and in cigar smokers who smoked heavily ( > 21 person-years of smoking; OR = 1.50; 95% CI: 1.10 - 1.95), compared with never-smokers.CONCLUSIONS. Consistent with other studies, tobacco smoking was strongly associated with a higher prevalence of nuclear and cortical cataracts and history of prior cataract surgery in this population. These findings suggest yet another need to educate the community on the importance of cessation of tobacco smoking and perhaps incorporating an antismoking message into school health programs.