Association of Environmental Factors with Age-Related Macular Degeneration using the Intelligent Research in Sight Registry.
Association of Environmental Factors with Age-Related Macular Degeneration using the Intelligent Research in Sight Registry.
复制标题
环境因素与年龄相关的黄斑变性的关联，使用视力注册表中的智能研究。
DOI：
10.1016/j.xops.2022.100195
复制
发表时间：
2022-12
影响因子：
--
通讯作者：
Manookin, Michael B.
中科院分区：
文献类型：
--
作者：
Hunt, Matthew S.;Chee, Yewlin E.;Saraf, Steven S.;Chew, Emily Y.;Lee, Cecilia S.;Lee, Aaron Y.;Manookin, Michael B.
调查美国各地自然环境暴露与渗出性和非渗出性年龄相关性黄斑变性 (AMD) 的关系。数据库研究。对 2016 年至 2018 年活跃在 IRIS 注册表中的年龄 ≥ 55 岁的患者进行了分析。根据国际疾病分类第十版修订版和现行程序术语 (CPT) 代码，将患者分为非渗出性、非活动性渗出性和活动性渗出性 AMD。没有与任何邮政编码列表区域匹配的提供者级邮政编码的患者被排除在外。环境数据来自公共来源，包括美国地质调查局、国家可再生能源实验室、国家海洋和大气管理局以及环境保护局。每个邮政编码制表区域随机截取的多变量、混合效应逻辑回归模型使用 3 个独立的模型量化了每个环境变量与任何 AMD 与非 AMD 患者、任何渗出性 AMD 与非渗出性 AMD 以及活动性渗出性 AMD 与非活动性渗出性和非渗出性 AMD 的关联，同时调整了年龄、性别、种族、保险类型、吸烟史和有晶状体眼状态。环境因素的优势比。总共纳入了 9 884 527 名患者。我们的模型中包含了海拔、纬度、全球水平辐照度 (GHI) 和直接法向辐照度 (DNI) 测量的太阳辐照度、温度和降水变量以及污染变量。与活动性渗出性 AMD 具有统计学显着相关性的是 GHI（优势比 [OR]，3.848；Bonferroni 校正的 95% 置信区间 [CI]，1.316–11.250）、DNI（OR，0.581；95% CI，0.370–0.913）、纬度（OR，1.110；95% CI， 1.046–1.178）、臭氧（OR，1.014；95% CI，1.004–1.025）和二氧化氮（OR，1.005；95% CI，1.000–1.010）。与 AMD 唯一显着的环境关联是冬季几英寸的降雪（OR，1.005；95% CI，1.001–1.009）和臭氧（OR，1.011；95% CI，1.003–1.019）。 AMD 亚组之间最强的环境关联有所不同。太阳变量 GHI、DNI 和纬度与活动性渗出性 AMD 显着相关。臭氧和二氧化氮这两个污染物变量也与 AMD 呈正相关。有必要进行进一步的研究来调查这些关联的临床相关性。我们精心策划的环境数据集已在 https://github.com/uw-biomedical-ml/AMD_environmental_dataset 上公开发布。
Investigate associations of natural environmental exposures with exudative and nonexudative age-related macular degeneration (AMD) across the United States. Database study. Patients aged ≥ 55 years who were active in the IRIS Registry from 2016 to 2018 were analyzed. Patients were categorized as nonexudative, inactive exudative, and active exudative AMD by International Classification of Diseases 10th Revision and Current Procedural Terminology (CPT) codes. Patients without provider-level ZIP codes matching any ZIP code tabulation area were excluded. Environmental data were obtained from public sources including the US Geological Survey, National Renewable Energy Laboratory, National Oceanic and Atmospheric Administration, and Environmental Protection Agency. Multiple variable, mixed effects logistic regression models with random intercepts per ZIP code tabulation area quantified the association of each environmental variable with any AMD versus non-AMD patients, any exudative AMD versus nonexudative AMD, and active exudative AMD versus inactive exudative and nonexudative AMD using 3 separate models, while adjusting for age, sex, race, insurance type, smoking history, and phakic status. Odds ratios for environmental factors. A total of 9 884 527 patients were included. Elevation, latitude, solar irradiance measured in global horizontal irradiance (GHI) and direct normal irradiance (DNI), temperature and precipitation variables, and pollution variables were included in our models. Statistically significant associations with active exudative AMD were GHI (odds ratio [OR], 3.848; 95% confidence interval [CI] with Bonferroni correction, 1.316–11.250), DNI (OR, 0.581; 95% CI, 0.370–0.913), latitude (OR, 1.110; 95% CI, 1.046–1.178), ozone (OR, 1.014; 95% CI, 1.004–1.025), and nitrogen dioxide (OR, 1.005; 95% CI, 1.000–1.010). The only significant environmental associations with any AMD were inches of snow in the winter (OR, 1.005; 95% CI, 1.001–1.009) and ozone (OR, 1.011; 95% CI, 1.003–1.019). The strongest environmental associations differed between AMD subgroups. The solar variables GHI, DNI, and latitude were significantly associated with active exudative AMD. Two pollutant variables, ozone and nitrogen dioxide, also showed positive associations with AMD. Further studies are warranted to investigate the clinical relevance of these associations. Our curated environmental dataset has been made publicly available at https://github.com/uw-biomedical-ml/AMD_environmental_dataset.
登录
查看更多内容
影响因子：
1.6
作者：
Kim KL;Park SP
通讯作者：
Park SP
影响因子：
13.7
作者：
Chiang, Michael F.;Sommer, Alfred;Parke, David W., II
通讯作者：
Parke, David W., II
影响因子：
2.1
作者：
HEIBA, IM;ELSTON, RC;KLEIN, R
通讯作者：
KLEIN, R
影响因子：
10.5
作者：
通讯作者：
--
影响因子：
0.2
作者：
Nair R;Maseeh A
通讯作者：
Maseeh A