身体测量值与年龄相关性白内障的关系

发布时间：2018-01-17 20:33

本文关键词：身体测量值与年龄相关性白内障的关系　出处：《辽宁医学院》2012年硕士论文　论文类型：学位论文

【摘要】：目的调查中老年人群临床术后年龄相关性白内障（ARC）及其所引起的视觉损害的流行病学现状，探讨社会人口学特征、生活方式因素、身体测量值、体力活动、膳食因素以及个体疾病既往史等与ARC发生发展的关系。方法采用以医院为基础的病例对照研究方法，病例为2010年4月~2011年10月，在锦州的三级甲等医院眼科病房住院，临床诊断为ARC，施行手术治疗，术后病理检验证实为ARC的360例患者，年龄为45~85岁。对照为因各种急性、非肿瘤性及非代谢性疾病同期入住相同医院的360例非白内障的患者。采用自行设计的调查表对所有研究对象进行调查，内容包括人口学特征、生活方式因素、个体疾病既往史等因素。同时对身体测量值指标身高、体重、腰围及臀围进行测量，并计算体质指数（BMI）和腰臀比（WHR）。采用SPSS13.0统计分析软件，对调查资料进行分析，比较各组间均值和率的差异。应用Logistic回归模型估计腰围（WC）、体质指数（BMI）、腰臀比（WHR）与ARC关联的比值比（OR）及其相应的95%可信区间（CI）。结果 1、共收集有效临床ARC病例和对照各360例，年龄45~85岁，病例年龄45~85岁，平均（69.20±10.39）岁；对照年龄45~85岁，平均（69.62±10.93）岁。人口统计学特征分析结果显示，2组研究对象的年龄、性别、民族、居住地、文化程度、职业、以及经济收入均无显著性差异（P0.05）。 2、BMI增高与发生ARC的危险性呈正相关。超重和肥胖者（24.00~27.99和≥28.00）发生ARC的危险性约是正常BMI（18.50~24.99）者的1.6倍（OR=1.587，95%CI：1.135~2.218，P=0.007）和2.3倍（OR=2.315，95%CI：1.369~3.914，P=0.002）。与BMI最低四分位数(16.96~21.16)的对照组相比较，病例组最高四分位数（25.11~32.18）者ARC的发病危险性明显增加（OR=2.645，95%CI：1.887~3.656，P=0.003）。 3、WHR增高与ARC发病危险性的增加有关。向心性肥胖者发生ARC的危险性显著增高，与正常体型者（男性WHR 0.9；女性WHR 0.88）相比，WHR≥0.9男性和WHR≥0.88女性发生ARC的危险性分别增加了69%（OR=1.689，95%CI：1.496~2.538，P=0.006）和53%（OR=1.534，95%CI：1.183~2.345，P=0.019）。 4、高血压与ARC呈显著正相关（OR=1.573，95%CI：1.145~2.161，P=0.005）。随着收缩压的升高，ARC的发生率明显增加。与收缩压140mmHg者相比，收缩压≥180mmHg者发病的危险性增加（OR=2.812，95%CI：1.450~5.455，P=0.002）。不同BMI的研究对象高血压状况与ARC的关系不同，，BMI正常（18.50~23.99）者的血压升高与发生ARC无关（OR=1.333，95%CI：0.819~2.170，P=0.246）。然而，超重者罹患高血压可使发生ARC的危性显著增加（OR=1.991，95%CI：1.160~3.419，P=0.012），BMI≥28.00者的血压升高与ARC发病危险性呈显著正相关（OR=2.000，95%CI：1.747~5.355，P=0.008）。结论 1、结果提示，肥胖是发生ARC的重要危险因素，维持正常WHR或BMI是ARC发病的保护因素。 2、超重和肥胖者罹患高血压与发生ARC的危险性显著升高有关，维持正常血压对ARC有益。 3、收缩压升高及高血压病程可使ARC的发病危险性增加；而体力活动、骑自行车则与发生ARC的危险性降低有关。通过改善饮食习惯和生活方式，维持正常的BMI和WHR，可有效地预防ARC的发生。
[Abstract]:objective
Survey of elderly population in clinical postoperative cataract (ARC) epidemiological status and causes of visual impairment, to explore the social demographic characteristics, lifestyle factors, body measurements, physical activity, the relationship between dietary factors and individual disease history and ARC development.
Method
A hospital-based case-control study, cases for the April 2010 ~2011 year in October, in the ophthalmology ward of three hospitals in Jinzhou, the clinical diagnosis of ARC, surgical treatment, postoperative pathological examination confirmed 360 cases of ARC patients, aged 45~85 years old. The control for various acute, non neoplastic and non metabolic diseases during the same period in the same hospital 360 cases of cataract patients. Using a self-designed questionnaire survey was conducted on all subjects, including demographic characteristics, lifestyle factors, individual disease history and other factors. At the same time value to the body height, body weight measurement, waist and hip circumference were measured and calculated. Body mass index (BMI) and waist to hip ratio (WHR). Using SPSS13.0 statistical analysis software, analysis of survey data, the differences between groups were compared and the mean rate. The application of Logistic regression model to estimate the waist circumference (WC), Body mass index (BMI), the ratio of waist to hip ratio (WHR) to ARC (OR) and its corresponding 95% confidence interval (CI).
Result
1, the total number of valid clinical ARC cases and controls 360 cases, aged 45~85 years, were 45~85 years old, the average (69.20 + 10.39) years; in the age 45~85 years old, average (69.62 + 10.93) years old. Demographic analysis showed that 2 groups of subjects of age, gender, nationality, place of residence. Education, occupation, there were no significant differences in income and economy (P0.05).
2, BMI is associated with an increased risk of positive ARC. Overweight and obesity (24.00~27.99 = 28) the incidence of ARC is about 1.6 times the normal BMI (18.50~24.99) of the (OR=1.587,95%CI:1.135~2.218, P=0.007) and 2.3 times (OR=2.315,95%CI:1.369~3.914, P=0.002) and BMI. The lowest four percentile (16.96~21.16) control compared to the group, four cases were the highest quantile (25.11~32.18) risk of a significant increase in ARC (OR=2.645,95%CI:1.887~3.656, P=0.003).
3, WHR increased with the increase of ARC risk. The risk of obesity ARC increased significantly, and the normal person (male 0.9 female 0.88 WHR; WHR) compared to WHR risk more than 0.9 men and women aged 0.88 WHR ARC were increased by 69% (OR=1.689,95%, CI:1.496~2.538, P=0.006) and 53% (OR=1.534,95%CI:1.183~2.345, P=0.019).
4, hypertension was positively correlated with ARC (OR=1.573,95%CI:1.145~2.161, P=0.005). With the increase of systolic blood pressure, the incidence of ARC increased significantly. Compared with the 140mmHg systolic blood pressure, systolic blood pressure greater than 180mmHg increase the risk of onset (OR=2.812,95%CI:1.450~5.455, P=0.002).
The relationship between hypertension status and ARC study of different BMI different, BMI normal (18.50~23.99) of the blood pressure and the occurrence of ARC. (OR=1.333,95%CI:0.819~2.170, P=0.246). However, overweight hypertension can make the risk of ARC was significantly increased (OR=1.991,95%CI: 1.160~3.419, P=0.012, BMI = 28) increased the blood pressure and the risk ARC was significantly positively correlated (OR=2.000,95%CI:1.747~5.355, P=0.008).
conclusion
1, the results suggest that obesity is an important risk factor for the occurrence of ARC, and the maintenance of normal WHR or BMI is a protective factor for the pathogenesis of ARC.
2, high blood pressure in overweight and obese people is associated with a significant increase in the risk of ARC, and maintaining normal blood pressure is beneficial to ARC.
3, the increase in systolic pressure and the course of hypertension can increase the risk of ARC, while physical activity and cycling are associated with the risk of ARC.
The maintenance of normal BMI and WHR can effectively prevent the occurrence of ARC by improving the eating habits and lifestyle.

【学位授予单位】：辽宁医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R776.1

【参考文献】