目的:探讨中老年人膳食碳水化合物及脂肪摄入量与年龄相关白内障(age-related cataract,ARC)危险性之间的关系。方法:采用以医院为基础的病例对照研究方法。病例由45～85岁的360例白内障患者组成,对照由同期入住相同医院的360例非白内障的患者组成,采取1∶1匹配。采用自行设计的调查表对研究对象进行调查,内容包括人口学特征、生活方式、以及既往史等,同时还采用一份有效的半定量化食物频率调查表(FFQ),获取研究对象膳食营养素的摄入情况。应用多因素Logistic回归分析估计碳水化合物及脂肪摄入量与ARC关联的比值比(OR)及其相应的95%可信区间(CI)。结果:调整多种潜在性混杂因素后,碳水化合物摄入量增加可使发生ARC的危险性升高,与摄入量为最低四分位数的对照相比较,摄入量为最高四分位数的病例发生ARC的OR为2.161(95%CI:1.107～5.016,P<0.001)。同样,多不饱和脂肪酸摄入量也与ARC呈正相关,摄入量为最高四分位数的病例发生ARC危险性是最低四分位数对照的3倍(OR=2.989,95%CI:1.764～5.062,P<0.001)。总脂肪摄入量与ARC无关(P=0.778)。结论:膳食碳水化合物及多不饱和脂肪酸摄入量增加可使发生ARC的危险性升高,合理营养、平衡膳食可能有助于预防ARC。

AIM:To examine relation between dietary carbohydrate and fat intake and the risk of age-related cataract(ARC) in middle-aged and elderly men.METHODS:A hospital-based case control study was conducted.Cases(n=360) were patients with cataract 45-85 years old,and controls(n=360) were patients who had been admitted to the same hospital for diseases not related with cataract.Cases and controls were matched with 1:1.All subjects were interviewed using a structured interviewer-administrated questionnaire that included information on socio-demographic characteristics,lifestyle habits and detailed medical history,simultaneously,the dietary intakes of nutrients were collected via a valid semi-quantitative food frequency questionnaire(FFQ).The odds ratios(OR) and 95% confidence intervals(CI) of ARC were estimated using multiple logistic regression models.RESULTS:After adjusting for multiple potential confounders,higher dietary intake of carbohydrate was associated with an increased risk of ARC.Compared to controls in the lowest quartile,the OR for cases in the highest quartile of intake was 2.161(95% CI:1.107-5.016,P<0.001).Similarly,there was a positive association between intake of polyunsaturated fatty acids and ARC.Participants in the highest quartile of polyunsaturated fatty acids intake had approximately three times the risk of ARC as did those in the lowest quartile(OR=2.989,95% CI:1.764-5.062,P <0.001).Dietary total fat intake was not associated with ARC(P=0.778).CONCLUSION:High carbohydrate and polyunsaturated fatty acid intake may increase the odds of ARC,and a healthy well-balanced diet can be used to protect ARC.

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