Racial and Ethnic Differences in the Roles of Myopia and Ocular Biometrics as Risk Factors for Primary Open-Angle Glaucoma.
Racial and Ethnic Differences in the Roles of Myopia and Ocular Biometrics as Risk Factors for Primary Open-Angle Glaucoma.
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DOI：
10.1167/iovs.64.7.4
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发表时间：
2023-06-01
影响因子：
4.4
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中科院分区：
文献类型：
--
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评估屈光不正（RE）和眼部生物特征作为原发性开角型青光眼（POAG）风险因素的作用如何因人种和种族而异。回顾性分析了两项基于人群的流行病学研究--洛杉矶拉丁裔眼科研究（LALES）和美籍华人眼科研究（CHES）的数据。进行多变量logistic回归和交互作用项分析，以评估POAG与其危险因素（包括RE和眼轴长度（AL））之间的关系，并评估人种/种族的效应改变。分析包括7601名年龄≥ 50岁的LALES（47.3%）和CHES（52.7%）有晶状体眼参与者。平均年龄为60.6 ± 8.3岁; 60.9%为女性。LALES组POAG的患病率和未校正风险均高于CHES组（分别为6.0%和4.0%;比值比[OR] = 1.55; P < 0.001）。在多变量分析中，POAG的显著危险因素包括拉丁裔（OR = 2.25; P < 0.001）、屈光性近视（与非近视相比，轻度OR = 1.54，中度OR = 2.47，高度OR = 3.94; P ≤ 0.003）和较长的AL（OR = 1.37/mm; P < 0.001）。AL（标准回归系数[SRC] = 0.3）与POAG的相关性是高度近视状态（SRC = 0.11）的2.7倍。人种/种族对RE（每屈光度）或AL（每毫米）与POAG之间的相关性没有改变作用（P = 0.49）。虽然近视RE和较长AL所带来的POAG风险在拉丁裔和华裔美国人之间相似，但两组POAG患病率的差异因华裔美国人的近视患病率较高而缩小。在全球近视流行的背景下，近视发病率较高的种族/民族人群可能会受到POAG的不成比例的影响。
Assess how the roles of refractive error (RE) and ocular biometrics as risk factors for primary open-angle glaucoma (POAG) differ by race and ethnicity. Data from the Los Angeles Latino Eye Study (LALES) and the Chinese American Eye Study (CHES), two population-based epidemiological studies, were retrospectively analyzed. Multivariable logistic regression and interaction term analyses were performed to assess relationships between POAG and its risk factors, including RE and axial length (AL), and to assess effect modification by race/ethnicity. Analysis included 7601 phakic participants of LALES (47.3%) and CHES (52.7%) with age ≥ 50 years. Mean age was 60.6 ± 8.3 years; 60.9% were female. The prevalence and unadjusted risk of POAG were higher in LALES than CHES (6.0% and 4.0%, respectively; odds ratio [OR] = 1.55; P < 0.001). In the multivariable analysis, significant risk factors for POAG included Latino ethnicity (OR = 2.25; P < 0.001), refractive myopia (OR = 1.54 for mild, OR = 2.47 for moderate, OR = 3.94 for high compared to non-myopes; P ≤ 0.003), and longer AL (OR = 1.37 per mm; P < 0.001). AL (standardized regression coefficient [SRC] = 0.3) was 2.7-fold more strongly associated with POAG than high myopia status (SRC = 0.11). There was no modifying effect by race/ethnicity on the association between RE (per diopter) or AL (per millimeter) and POAG (P = 0.49). Although the POAG risk conferred by myopic RE and longer AL is similar between Latino and Chinese Americans, the difference in POAG prevalence between the two groups is narrowed by higher myopia prevalence among Chinese Americans. Racial/ethnic populations with higher myopia incidence may become disproportionately affected by POAG in the context of the global myopia epidemic.
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