Sun exposure and age-related macular degeneration - An Australian case-control study
Sun exposure and age-related macular degeneration - An Australian case-control study
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DOI：
10.1016/s0161-6420(97)30235-8
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发表时间：
1997-05-01
期刊：
影响因子：
13.7
通讯作者：
Heller, RF
中科院分区：
文献类型：
--
作者：
Darzins, P;Mitchell, P;Heller, RF
背景资料：阳光照射是年龄相关性黄斑变性（AMD）的一个危险因素的概念是普遍的，但研究还没有表明这一结论。方法：要测试的假设，AMD病例有更大的眼睛阳光照射比对照组，作者比较了409例286名对照组居民在纽卡斯尔，澳大利亚。对参与者的太阳和眩光的敏感性进行了表征。根据详细的病史估计日光暴露，并根据预期的日光寻求或避免行为进行验证，考虑到日光敏感性和皮肤肿瘤治疗史。与作者的假设相反，对照组受试者的年平均眼部阳光照射量（865小时）与（723小时）相比，Mann-Whitney U（U）= 45704，z =-4.9，P> 0.0001。病例的晒黑程度比对照组差（X-2 = 18.2，4 df，P = 0.001），年轻人对眩光更敏感，OR为2.5; 95%置信区间（Cls），1.8至3.5，在按晒黑能力分层后，在晒黑不良组中，对照组年日照时间中位数（685小时）超过病例组（619小时），U = 6556，z =-1.9，P = 0.06。在晒黑效果好的人群中，对照组的年日照时间也显著高于病例组（940 vs.770 h），U = 16263，z =-3.7，P = 0.0002。结论：眩光敏感和晒黑能力差是AMD风险增加的标志。太阳敏感性混淆了假设的AMD-阳光联系的研究。尽管按阳光敏感性分层分析，但对照组的阳光暴露量高于AMD患者。
Background: The notion that sun exposure is a risk factor for age-related macular degeneration (AMD) is widespread, but studies have not shown this conclusively.Methods: To test the hypothesis that AMD cases have greater ocular sun exposure than control subjects, the authors compared 409 cases with 286 control subjects resident in Newcastle, Australia. Sensitivity to sun and glare of the participants was characterized. Sun exposure was estimated from detailed histories and was validated against sun-seeking or avoidance behavior expected, given sun sensitivity and history of treatment for skin neoplasia.Results: Contrary to the authors' hypothesis, control subjects had greater median annual ocular sun exposure (865 hours) than cases (723 hours), Mann-Whitney U (U) = 45704, z = -4.9, P > 0.0001. Cases had poorer tanning than did control subjects (X-2 = 18.2, 4 df, P = 0.001) and as young adults were more sensitive to glare, odds ratio (OR), 2.5; 95% confidence intervals (Cls), 1.8 to 3.5, After stratifying by tanning ability, in the poor-tanning group, the median annual sun exposure of control subjects (685 hours) exceeded that of cases (619 hours), U = 6556, z = -1.9, P = 0.06. Among people who tanned well, control subjects also had significantly greater annual sun exposure than did cases (940 vs. 770 hours), U = 16263, z = -3.7, P = 0.0002.Conclusions: Sensitivity to glare and poor tanning ability are markers of increased AMD risk. Sun sensitivity confounds study of the postulated AMD-sunlight link. Despite analyses stratified by sun sensitivity, sun exposure was greater in control subjects than in cases with AMD.