目的：探讨中老年人高血压、糖尿病与年龄相关白内障（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例因患ARC施行白内障手术摘除的患者组成，对照由同期入住相同医院的360例非白内障患者组成，采取1∶1匹配。采用标准调查表对研究对象进行面对面调查，内容包括人口学特征、生活方式、疾病既往史等，同时对血压、血糖进行测量。应用多因素Logistic回归分析估计高血压及糖尿病与ARC关联的比值比（OR）及其相应的95%可信区间（CI）。 结果：在调整了年龄和性别因素后，高血压与ARC呈显著正相关（OR=1.573，P=0.005）。与收缩压正常者相比较，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）。高血压病程10a~的研究对象发病的危险性显著地高于病程 <10a者（OR=1867，95%CI：1.053~3.307，P=0.033）。同样，与非糖尿病患者相比，糖尿病患者发生ARC的危险性显著升高（OR=2.151，95%CI：1.470~3.149，P<0.001）。与非糖尿病患者相比，糖尿病病程 <10a和10~19a者发生ARC的OR分别为2.374（95%CI：1.502~3.752，P<0.001）和2.683（95%CI：1.267~5.683，P=0.010）。 结论：ARC患病率增高与高血压、糖尿病及其病程增加有关。对这些可变危险因素采取干预性措施，尤其是对高危人群，可能意味着对ARC导致的视觉障碍必须采取控制性措施，因为此症是全球致盲的首要原因。

AIM: To investigate the association between hypertension, diabetes 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. Blood pressure and blood glucose of study population were measured. Multiple logistic regression model was used to derive odds ratios (OR) and 95% confidence intervals (CI) for the association between hypertension and diabetes, and ARC. RESULTS: After adjusted for age and gender, hypertension was significant positively related with ARC (OR=1.573, P=0.005). Compared with normal systolic blood pressure,systolic blood pressure ≥180mmHg increased the risk of onset (OR=2.812, 95%CI: 1.450-5.455, P=0002). The duration of hypertension was associated with an increased risk of ARC, especially those men for 10 to 20 years (OR=1.867, 95%CI: 1.053-3.307, P=0.033). Similarly, there was a positive association between diabetic patients and ARC (OR=2.151, 95%CI: 1.470-3149, P<0.001). The risk of ARC in diabetes duration <10 years and 10 to 19 years significantly increased (OR =2.374; 95%CI: 1.502-3.752, P<0.001 and OR =2.683; 95%CI: 1.267-5.683, P=0.010 respectively). CONCLUSION: Hypertension and diabetes may increase the prevalence rate of ARC. Interventions to modify these risk factors, especially in populations in which they are highly prevalent, may have implications to control visual loss from cataract, which is the first cause of blindness worldwide.

中国辽宁省教育厅科学技术研究基金资助项目（No.2008424）