국민건강영양조사를 사용한 개방각녹내장의 위험 요인 분석
What Laboratory Examinations for Open-angle Glaucoma Risk Stratification
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목적: 본 연구는 국민건강영양조사(Korea National Health and Nutritional Examination Survey, KNHANES)를 분석하여 개방각녹내장(open angle glaucoma, OAG)과 연관된 혈액검사 결과를 확인하는 것을 목표로 하였다. 대상과 방법: 2008년부터 2012년까지의 KNHANES 대상자를 OAG군과 비녹내장군으로 분류하였으며, 연령, 성별, 교육정도, 조사년도를 보정한 다변량 분석을 시행하였다. 결과: OAG군과 대조군 간 연령, 성별, 교육수준에서 유의한 차이가 있었다. 보정 후의 다변량 분석에서 OAG군은 대조군에 비해 평균안압, 근시 정도, 수축기 혈압, 이완기 혈압이 더 높았고(p<0.001, p<0.001, p=0.002, p=0.002), 고혈압, 우울한 기분의 발병률이 더높았다(p=0.002, p=0.010). 또한, OAG군에서 AST/ALT 비가 높은 경향을 보였다(p=0.016). 로지스틱 회귀분석 결과, 높은 안압, 근시, 높은 수축기 혈압, 높은 이완기 혈압, 고혈압, 우울한 기분 그리고 높은 AST/ALT비가 OAG군의 위험 요인으로 확인되었다. 결론: 높은 평균 안압, 근시 정도, 고혈압 그리고 높은 AST/ALT 등 여러 위험 요인이 OAG와 연관성이 있음을 확인하였다. 특히 이연구는 AST/ALT비와 OAG가 관계가 있다는 것을 처음으로 밝혀냈다. 이 두 요인 간의 정확한 관계를 규명하기 위해서는 추가 연구가필요할 것이다.
Abstract
Purpose: We analyzed the laboratory examinations associated with open-angle glaucoma (OAG) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) to enhance our understanding of OAG risk factors. Methods: We categorized participants in KNHANES between 2008 and 2012 into OAG and non-glaucomatous groups. Next, we conducted a multivariate analysis, adjusting for age, sex, education level, and survey year. Results: Significant differences were observed in age, sex, and educational levels between the two groups. After propensity score matching, the OAG group demonstrated a significantly elevated intraocular pressure (IOP), myopia prevalence, systolic blood pressure (SBP), and diastolic blood pressure (DBP). In addition, that group exhibited a significantly increased prevalence of hypertension and melancholic mood disorders and aspartate transaminase/alanine transaminase (AST/ALT) ratio. Multiple logistic regression revealed elevated IOP, SBP, DBP, AST/ALT ratio, and prevalence of hypertension, melancholic mood, and myopia as OAG risk factors. Conclusions: Our study revealed several risk factors for OAG, including elevated IOP, SBP, DBP, AST/ALT ratio, and prevalence of hypertension, melancholic mood, and myopia. However, the mechanism underlying OAG remains uncertain. Notably, a positive correlation was observed between the AST/ALT ratio and OAG risk. Further studies are needed to evaluate this association.
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