Racial differences in age-related macular degeneration rates in the United States: a longitudinal analysis of a managed care network.
Racial differences in age-related macular degeneration rates in the United States: a longitudinal analysis of a managed care network.
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DOI：
10.1016/j.ajo.2011.02.004
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发表时间：
2011-08
影响因子：
4.2
通讯作者：
Stein, Joshua D.
中科院分区：
文献类型：
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作者：
VanderBeek, Brian L.;Zacks, David N.;Talwar, Nidhi;Nan, Bin;Musch, David C.;Stein, Joshua D.
目的比较美国不同种族非渗出性和渗出性年龄相关性黄斑变性（AMD）的发病率、患病率和危害。设计回顾性纵向队列研究。方法回顾了2001年至2007年在美国大型国家管理式医疗网络中登记的2 259 061名年龄≥40岁受益人的所有就诊记录，并确定了非渗出性和渗出性AMD的发病率和患病率，并按种族分层。Cox回归分析确定了每个种族的非渗出性和渗出性AMD的危害，并对混杂因素进行了调整。结果研究期间，113 234例（5.0%）诊断为非渗出性AMD， 17 181例（0.76%）诊断为渗出性AMD。校正混杂因素后，黑人在60岁时发生非渗出性AMD（风险比[HR] = 0.75, 95%可信区间[CI]: 0.71-0.79）和渗出性AMD （HR = 0.70, 95% CI: 0.59-0.83）的风险显著降低，在80岁时发生非渗出性AMD （HR = 0.56, 95% CI: 0.52-0.60）和渗出性AMD （HR = 0.45, 95% CI: 0.37-0.54）的风险相对于白人显著降低。拉丁美洲人在80岁时患非渗出性AMD的风险比白人低18% （HR = 0.82, 95% CI: 0.76-0.88）。亚裔美国人在60岁时患非渗出性AMD的风险增加28% (HR = 1.28, 95% CI: 1.20-1.36)，但在80岁时患渗出性AMD的风险降低46% （HR = 0.54, 95% CI: 0.40-0.73）。结论少数种族，包括拉丁裔和亚裔美国人，似乎没有类似的风险发展非渗出性和渗出性AMD与白人。应使用其他来源进行其他研究，以确定本研究结果对其他群体的普遍性。
PURPOSETo compare the incidence, prevalence, and hazard of nonexudative and exudative age-related macular degeneration (AMD) among different races throughout the United States.DESIGNRetrospective longitudinal cohort study.METHODSBilling records of all encounters for 2 259 061 beneficiaries aged ≥40 enrolled in a large, national US managed care network from 2001 through 2007 were reviewed and the incidence and prevalence of nonexudative and exudative AMD were determined and stratified by race. Cox regression analyses determined the hazard of nonexudative and exudative AMD for each race, with adjustment for confounders.RESULTSDuring the study, 113 234 individuals (5.0%) were diagnosed with nonexudative and 17 181 (0.76%) with exudative AMD. After adjustment for confounders, blacks had a significantly reduced hazard of nonexudative (hazard ratio [HR] = 0.75, 95% confidence interval [CI]: 0.71–0.79) and exudative AMD (HR = 0.70, 95% CI: 0.59–0.83) at age 60 and a reduced hazard of nonexudative (HR = 0.56, 95% CI: 0.52–0.60) and exudative AMD (HR = 0.45, 95% CI: 0.37–0.54) at age 80 relative to whites. Similar comparisons for Latinos demonstrated an 18% reduced hazard for nonexudative AMD at age 80 (HR = 0.82, 95% CI: 0.76-0.88) relative to whites. Asian Americans showed a 28% increased hazard for nonexudative AMD at age 60 (HR = 1.28, 95% CI: 1.20–1.36) but a 46% decreased hazard for exudative AMD at age 80 (HR = 0.54, 95% CI: 0.40–0.73).CONCLUSIONSRacial minorities, including Latinos and Asian Americans, do not appear to have similar risks of developing nonexudative and exudative AMD as whites. Additional studies using other sources should be conducted to determine the generalizability of this study's findings to other groups.
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影响因子：
13.7
作者：
Klein, R;Klein, BEK;Jacobs, DR
通讯作者：
Jacobs, DR
影响因子：
13.7
作者：
Kawasaki, Ryo;Wang, Jie Jin;Wong, Tien Yin
通讯作者：
Wong, Tien Yin
影响因子：
13.7
作者：
Friedman, DS;Katz, J;Tielsch, JM
通讯作者：
Tielsch, JM
影响因子：
--
作者：
Klein, Ronald;Knudtson, Michael D.;Klein, Barbara E. K.
通讯作者：
Klein, Barbara E. K.
影响因子：
4.2
作者：
Li, Yibin;Xu, Liang;Li, Jianjun
通讯作者：
Li, Jianjun