중심장액맥락망막병증과 뇌졸중 및 허혈심장질환 위험도: 표본코호트를 이용한 인구기반 연구
Is Central Serous Chorioretinopathy a Risk Factor for Neurocardiovascular Disease Development?: 10-year Nationwide Population-based Study
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목적: 중심장액맥락망막병증과 뇌졸중 및 허혈심장질환 발생의 위험도 상관관계를 분석하고자 하였다. 대상과 방법: 국민건강보험공단에서 2002년부터 2015년까지 전 인구를 대표하여 구축한 표본코호트 데이터베이스(1,025,340명) 자료를 이용하여 2006년 1월부터 2010년 12월까지 중심장액맥락망막병증으로 진단받은 환자군과 5배수 대조군을 포함하였다. 대조군은 나이, 성별, 거주지, 가계소득으로 기준으로 환자군의 5배수로 설정하였다. 환자군과 대조군을 2015년까지 추적하여 두 군 간의 뇌졸중 및 허혈심장질환의 발생률을 비교 분석하였다. 결과: 환자군과 대조군에서 해당 기간 동안 뇌졸중은 각각 4.41%와 4.11%에서 발생하였으며 허혈심장질환은 7.93%와 7.27% 발생하였다. 다변량 Cox 비례 회귀분석 사용하여 분석한 결과 중심장액맥락망막병증은 뇌졸중(hazard ratio [HR], 0.964; 95% confidence interval [CI], 0.65-1.424; p=0.8532)과 허혈심장질환(HR, 0.942; 95% CI, 0.694-1.279; p=0.7018) 발생과 상관관계가 없는 것으로나타났다. 나이대별, 뇌졸중의 타입별 하위분석에서도 중심장액맥락망막병증은 뇌심혈관계질환의 발생과 상관관계가 없는 것으로 나타났다. 결론: 포본코호트를 이용하여 10년간 추적 관찰한 결과 중심장액맥락망막병증은 뇌졸중 및 허혈심장질환의 발생률과는 상관관계가 없는 것으로 나타났다. 향후 추가적인 전향적 임상연구를 통해서 중심장액맥락망막병증과 뇌심혈관계질환의 위험도에 대한 연구가 필요하다.
Abstract
Purpose: We evaluated the risk of neurocardiovascular disease development after central serous chorioretinopathy (CSC). Methods: We collected data from the Korean National Health Insurance Research Database (which contains information on 1,025,340 [2.2%] random subjects selected from all Korea residents in 2002). Patients diagnosed with CSC, stroke, or ischemic heart disease (IHD) from 2002 to 2005 were excluded. The CSC group featured patients initially diagnosed with CSC from January 2006 to December 2010. The comparison group included randomly selected patients (five per CSC patient) matched to CSC patients by age, sex, residential area, and household income. Results: Stroke developed in 4.41% of the CSC group and 4.11% of the comparison group. IHD developed in 7.93% of the CSC group and 7.27% of the comparison group. CSC was not significantly associated with an increased risk of stroke (hazard ratio [HR], 0.964; 95% confidence interval [CI], 0.65-1.424; p = 0.8532) or IHD (HR, 0.942; 95% CI, 0.694-1.279; p = 0.7018) after adjusting for demographic characteristics and comorbidities. Subgroup analyses by age group and stroke subtype revealed no significant associations with CSC or IHD status. Conclusions: CSC was not associated with stroke or IHD development in patients of any age after adjusting for potential confounders. Further studies are needed to confirm a relationship between CSC and development of systemic cardiovascular disease.
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