Body mass index and the incidence of visually significant age-related maculopathy in men.
Body mass index and the incidence of visually significant age-related maculopathy in men.
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DOI：
10.1001/archopht.119.9.1259
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发表时间：
2001-09
影响因子：
--
通讯作者：
D. Schaumberg;W. Christen;S. Hankinson;R. Glynn
中科院分区：
文献类型：
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作者：
D. Schaumberg;W. Christen;S. Hankinson;R. Glynn
背景报告表明体重与年龄相关性黄斑病（ARM），特别是其非新生血管（干性）形式的关系，但结果不一致且前瞻性数据稀缺。目的 在平均 14.5 年的随访期间前瞻性研究体重指数（BMI；计算方法为体重（公斤）除以身高（米）的平方）与视觉上显着的干性和新生血管 ARM 的关系。方法 通过对参与医生健康研究的 21 121 名男性中自我报告的 ARM 的医疗记录确认来评估事件 ARM，这些男性 (1) 随访至少 7 年，(2) 在基线时没有视觉上显着的 ARM，(3) 有 BMI 和吸烟信息。我们使用比例风险回归模型来估计 4 个 BMI 类别内视觉显着的干性 ARM（256 例）和新生血管性 ARM（84 例）的比率 (RR) 和 95% 置信区间 (CI)：瘦（或 = 30.0）。结果 调整年龄、随机阿司匹林和 β 胡萝卜素分配以及吸烟情况后，BMI 正常的男性中视觉显着的干 ARM 的发生率最低。与这些男性相比，RR（95% CI）如下：瘦男性为 1.43（1.01-2.04），超重男性为 1.24（0.93-1.66），肥胖男性为 2.15（1.35-3.45）。尽管BMI与新生血管性ARM的诊断没有显着关系，但由于病例数较少，这些分析不能排除重要关系。结论 肥胖是男性视觉上显着 ARM 的危险因素，尤其是干性 ARM。然而，BMI 与干性 ARM 的关系似乎呈 J 形，最瘦的人似乎也面临更高的风险。
BACKGROUND Reports have suggested relationships of body weight with age-related maculopathy (ARM), particularly its nonneovascular (dry) forms, but results are inconsistent and prospective data are scarce. OBJECTIVE To examine prospectively relationships of body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) with visually significant dry and neovascular ARM during an average of 14.5 years of follow-up. METHODS Incident ARM was assessed by medical record confirmation of self-reported ARM among the 21 121 men participating in the Physicians' Health Study who (1) were followed up for at least 7 years, (2) were free of visually significant ARM at baseline, and (3) had information on BMI and cigarette smoking. We used proportional hazards regression models to estimate rate ratios (RRs) and 95% confidence intervals (CIs) for visually significant dry ARM (256 cases) and neovascular ARM (84 cases) within 4 categories of BMI: lean ( or = 30.0). RESULTS Adjusting for age, randomized aspirin and beta carotene assignments, and cigarette smoking, the incidence for visually significant dry ARM was lowest in men with a normal BMI. Compared with these men, the RRs (95% CIs) were as follows: 1.43 (1.01-2.04) for lean, 1.24 (0.93-1.66) for overweight, and 2.15 (1.35-3.45) for obese men. Although there was no significant relationship of BMI with the diagnosis of neovascular ARM, due to the small number of cases these analyses could not rule out an important relationship. CONCLUSIONS Obesity is a risk factor for visually significant ARM in men, in particular for dry ARM. However, the relationship of BMI with dry ARM appears to be J-shaped, and the leanest individuals also appear to be at increased risk.