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目的 探讨血脂水平和年龄相关性黄斑变性(age-related macular degeneration,AMD)的关系.方法 选取2017年1—12月在华中科技大学同济医学院附属同济医院进行健康体检的40岁及以上的受检者,经详细问诊和全面眼科检查及健康体格检查,排除恶性肿瘤、脑卒中、心肌梗死、肺心病、高血压、糖尿病、肾病等严重慢性疾病患者后,纳入1 009例确诊为早期AMD的患者为AMD组, 3 489例同期进行健康体检的非AMD者为非AMD组,并对两组总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)进行比较分析.结果 AMD组平均年龄、男性构成比均高于非AMD组(P均<0.05).多元线性回归分析结果显示,调整年龄、性别、体质指数(BMI)混杂因素后,HDL-C与AMD有相关性(β=-0.026,95%CI :0.045～0.006,P=0.011),TC、TG、LDL-C与AMD无相关性(P均>0.05).结论 HDL-C水平降低与早期AMD相关,HDL-C可能是该病的保护因素,值得进一步研究.

Objective To investigate the relationship of age-related macular degeneration (AMD) with blood-lipid levels. Methods Individuals 40 years old or older who had undergone a physical-health examination in our hospital between January and December 2017 were enrolled in this study. Information regarding medical history and the results of essential ophthalmological and physical-health examinations were examined to exclude individuals with serious chronic diseases such as malignant tumors, stroke, myocardial infarction, pulmonary heart disease, hypertension, diabetes, and kidney disease. One thousand nine individuals with AMD (all at the early stage) were included in the AMD group, and 3489 individuals without AMD were included in the non-AMD group. Data of all participants, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels, were collected and analyzed. Results The average age in the AMD group was higher than that in the non-AMD group, and the male to female ratio was significantly higher in the AMD group (P<0.05). After adjusting for age, gender, and BMI confounders, multiple linear stepwise regression analysis revealed that HDL-C was associated with AMD (β=-0.026, 95% CI: 0.045-0.006, P=0.011); there was no correlation between TC, TG, LDL-C, and AMD (all P>0.05). Conclusion Early stage AMD was related to a decrease in HDL-C, which may be a protective factor against AMD. Further study is warranted to validate this finding.