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362例ARC男性患者组成，对照为同期入住相同医院，经频数匹配的362例患其它疾病的男性，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、社会经济状况、生活方式(吸烟和饮酒等)、身体测量值、个体疾病既往史以及一级亲属白内障家族史等，并计算BMI。采用多因素Logistic回归分析估计各因素与ARC关系的比值比(OR)及其95%可信区间(CI)。

结果：调整年龄和多种混杂因素后的分析结果表明，吸烟、吸烟时间及吸烟1～29支/d与发生ARC的危险性无关(P>0.05)。但吸烟≥30支/d与不吸烟者比较，发生ARC的危险性增加(OR=1.55，95%CI：1.16～2.85，P =0.026)。与正常BMI(18.5～)者相比，无论是瘦弱(<18.5)，还是超重(24.0～)或肥胖(≥28)者发生ARC的危险性明显升高(分别为OR=1.34，95%CI：1.03～1.64，P=0.019； OR=1.55，95%CI：1.02～1.98，P=0.015； OR=1.71，95% CI：1.32～2.39，P=0.013)。与BMI最低四分位数的对照组相比较，病例组BMI最高四分位数者发生ARC的危险性显著增加(OR=1.54，95% CI：1.08～2.46，P=0.022)。经单因素分析的结果表明，BMI较低和正常者吸烟与ARC无关(P>0.05)。但超重或肥胖者吸烟与发生ARC的危险性显著增加，分别为不吸烟者的2和1.7倍(OR=2.00，95%CI：1.49～6.65，P=0.003和OR=1.66，95% CI：1.63～13.21，P=0.002)。同样，BMI为最高四分位数吸烟者发生ARC危险性约是不吸烟者1.5倍(OR=1.46，95% CI：1.06～5.29，P<0.001)。进一步多因素分析的结果并未发生改变。

结论：男性吸烟 ≥30支/d与ARC呈正相关，超重和肥胖的男性吸烟发生ARC的危险性显著地升高。

METHODS: A hospital-based case control study was conducted. Cases(n=362)were men who had surgically treated ARC, 45-85 years old; controls frequency-matched(n=362)were men who had been admitted to the same hospital as cases for many different diseases not related with eye diseases. Cases and controls were matched with 1:1. The cases and controls were interviewed during their hospital stay, using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, socioeconomic, lifestyle habits(tobacco smoking and alcohol consumption, etc.), anthropometric measures, personal medical history, and family history of ARC in first-degree relatives, and simultaneously body mass index(BMI)was calculated. The odds ratios(OR)and 95% confidence intervals(CI)of ARC were estimated using multiple logistic regression models.

RESULTS: After adjusting for age and multiple potential confounders, higher BMI was associated with an increased risk of ARC. Cigarette smoking, years smoked or moderate cigarette smoking(1-29 cigarettes/day)had no relation with the risk of ARC(P>0.05), although patients smoked ≥30 cigarettes per day had an elevated risk of ARC as compared with the non-smokers(OR=1.55, 95% CI; 1.16-2.85, P=0.026). Higher BMI was associated with an increased risk of ARC. Both overweight and obesity was associated with an obviously increased risk for surgically ARC(OR =1.55, 95% CI: 1.02-1.98, P=0.015 and OR=1.71, 95% CI: 1.32-2.39, P=0.013 respectively)compared to normal BMI. Then participants were grouped into quartiles of BMI(Q1 to Q4), compared to controls in the lowest quartile, the OR for cases in the highest quartile of BMI was 1.54(OR=1.54, 95% CI: 1.08-2.46, P=0.022). The results of univariate analysis showed cigarette smoking was not associated with ARC formation for men with lower or normal BMI(P >0.05).Compared to the non-smokers, for men of overweight or obesity, cigarette smoking was associated with a significantly increased risk for surgically ARC(OR=2.00, 95% CI: 1.49-6.65, P=0.003 and OR=1.66, 95% CI: 1.63-13.21, P=0.002 respectively). Similarly, smokers in the highest quartile of BMI had approximately 1.5 times the risk of ARC as non-smokers in the lowest quartile(OR=1.46, 95% CI: 1.06-5.29, P <0.001). Followed multivariate models revealed that the association had never changed.

CONCLUSION: Current cigarette smoking was positively related to ARC only among those who smoked 30 or more cigarettes/day. For men who were both overweight and obesity, cigarette smoking was associated with a significantly increased risk for ARC.