多种慢性病对年龄相关性黄斑变性风险的影响及其交互效应研究

Background  Age-related macular degenerationAMD is the leading cause of vision loss and impairment among individuals aged 50 and above worldwidewith an estimated 288 million people projected to be affected by 2040. Objective  To investigate the association between various chronic diseases and AMDanalyze the interaction effects of different chronic disease combinations on AMD riskand assess how the interaction between chronic diseases impacts AMD risk. Methods  Based on the Cheeloo LEAD databaseindividuals aged 50 years and above were included. The AMD group was identified using ICD-10 codingH35.3and a 14 matching by age and gender was conducted to select a control group without AMD. Significant differences in baseline characteristics and chronic disease prevalence were found between the AMD and non-AMD groups. Multivariate Logistic regression models were used to assess the association between AMD and chronic conditions such as hypertensiondiabetesand heart disease. Collinearity was evaluated using the variance inflation factorVIFto ensure the robustness of the model. Interaction terms were introduced to evaluate the synergistic effects of different chronic disease combinations on AMD risk. Results  A total of 16 780 participants were included in this studywith 3 356 in the AMD group and 13 424 in the control group. After adjusting for confounding factorsmultivariate Logistic regression analysis showed that hypertensionOR=2.8195%CI=2.59-3.04heart diseaseOR=2.0295%CI=1.86-2.19strokeOR=1.82 95%CI=1.66-1.99diabetesOR=2.7295%CI=2.47-2.99dyslipidemiaOR=2.0195%CI=1.78-2.28chronic gastric or digestive system diseasesOR=1.9095%CI=1.72-2.10chronic liver diseasesOR=2.2995%CI=2.04- 2.57emotional and mental disordersOR=2.8695%CI=2.49-3.29and memory-related diseasesOR=1.86 95%CI=1.52-2.28 were all significant risk factors for AMDP<0.05. Interaction effect analysis revealed that the predicted probability of AMD was 0.4 when hypertension and diabetes coexisted0.4 for the coexistence of diabetes and dyslipidemiaand 0.45 for the coexistence of chronic liver diseases and diabetes. The predicted probability of AMD was 0.3 for the combination of hypertension and heart disease0.3 for the combination of stroke and heart disease0.3 for the combination of chronic gastric diseases and chronic liver diseases0.4 for the combination of emotional and mental disorders and memory-related diseasesand 0.45 for the combination of hypertension and emotional and mental disorders. Conclusion  Hypertensiondiabeteschronic liver diseasesand other conditions were significantly associated with the occurrence of AMD. Notablythe combinations of chronic liver diseases and diabetesemotional and mental disorders with memory-related diseasesand hypertension with diabetes had an even more pronounced impact on AMD.