Association Between PM2.5 Exposure Level and Primary Open-Angle Glaucoma in Taiwanese Adults: A Nested Case–control Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Collection of PM2.5 Concentration Data
2.3. Study Population
2.4. Comorbidities
2.5. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. OR of PM2.5 Exposure as Risk Factor for POAG by Logistic Regression
3.3. ORs of PM2.5 Level As a Risk Factor for POAG in Subgroups.
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Comparison | POAG | P-value | ||||
---|---|---|---|---|---|---|
(n = 2580) | (n = 645) | |||||
Gender | ||||||
Female | 1228 | (47.6%) | 307 | (47.6%) | 1.0000 | |
Male | 1352 | (52.4%) | 338 | (52.4%) | ||
Age | ||||||
Mean ± SD | 72.64 ± 5.58 | 72.57 ± 5.66 | 0.7915 | |||
Low income | ||||||
Yes | 1620 | (62.79%) | 405 | (62.79%) | 1.0000 | |
No | 960 | (37.21%) | 240 | (37.21%) | ||
Urbanization level | ||||||
Highly urbanized | 563 | (21.82%) | 198 | (30.7%) | <.0001 | |
Moderate urbanization | 667 | (25.85%) | 180 | (27.91%) | ||
Emerging town | 402 | (15.58%) | 79 | (12.25%) | ||
General town | 489 | (18.95%) | 105 | (16.28%) | ||
Aged Township | 101 | (3.91%) | 21 | (3.26%) | ||
Agricultural town | 195 | (7.56%) | 37 | (5.74%) | ||
Remote township | 163 | (6.32%) | 25 | (3.88%) | ||
Comorbidity | ||||||
Hypertension | 1616 | (62.64%) | 449 | (69.61%) | 0.0010 | |
Ischemic heart disease | 452 | (17.52%) | 146 | (22.64%) | 0.0048 | |
Hyperlipidemia | 879 | (34.07%) | 313 | (48.53%) | <.0001 | |
Conge stive heart failure | 256 | (9.92%) | 77 | (11.94%) | 0.1523 | |
Peripheral vascular disease | 157 | (6.09%) | 56 | (8.68%) | 0.0002 | |
Atrial fibrillation | 64 | (2.48%) | 34 | (5.27%) | 0.0028 | |
Ischemic stroke | 85 | (3.29%) | 19 | (2.95%) | 0.6539 | |
Headaches | 438 | (16.98%) | 137 | (21.24%) | 0.0047 | |
Migraines | 75 | (2.91%) | 29 | (4.5%) | 0.0716 | |
Epilepsy and recurrent | 41 | (1.59%) | 16 | (2.48%) | 0.1775 | |
Dementia | 173 | (6.71%) | 44 | (6.82%) | 0.9161 | |
Rheumatoid arthritis | 82 | (3.18%) | 24 | (3.72%) | 0.5093 | |
Systemic lupus erythematosus | 3 | (0.12%) | 2 | (0.31%) | 0.3979 | |
Diabetes | 689 | (26.71%) | 226 | (35.04%) | <.0001 | |
Asthma | 622 | (24.11%) | 161 | (24.96%) | 0.6516 | |
Chronic kidney disease | 131 | (5.08%) | 39 | (6.05%) | 0.3489 | |
Hepatitis B | 39 | (1.51%) | 12 | (1.86%) | 0.5505 | |
Fluid, Electrolyte, Acid–Base Disorders | 55 | (2.13%) | 23 | (3.57%) | 0.0678 | |
Tuberculosis | 63 | (2.44%) | 16 | (2.48%) | 0.9546 | |
Anemia | 274 | (10.62%) | 102 | (15.81%) | 0.0009 | |
Peptic ulcer | 170 | (6.59%) | 66 | (10.23%) | 0.0049 | |
Depression | 52 | (2.02%) | 16 | (2.48%) | 0.4893 | |
Malignant disease | 310 | (12.02%) | 105 | (16.28%) | 0.0074 |
n (%) | Distribution of PM2.5 (μg/m3) | Odd ratio (95% CI) | |||||
---|---|---|---|---|---|---|---|
Comparison | POAG | Median | Mean (SD) | Follow up Months Mean (SD) | Univariate | Multivariate | |
Total participants | |||||||
Per WHO standard level increase | 2580 | 645 | 1159.84 | 1262.18 (629.57) | 48.05 (15.07) | 1.248 (1.106–1.408) | 1.193 (1.050–1.356) |
PM2.5 WHO standard level (reference: normal standard) | |||||||
Normal level | 210 (8.14%) | 56 (8.56%) | 691.30 | 688.4 (283.57) | 43.30 (16.05) | Reference | Reference |
WHO 1.0 level | 1457 (56.47%) | 318 (48.62%) | 1046.42 | 1080.31 (469.86) | 42.90 (15.08) | 0.818 (0.595–1.126) | 0.825 (0.588–1.158) |
WHO 1.5 level | 797 (30.89%) | 209 (31.96%) | 1478.70 | 1569.97 (680.75) | 52.00 (13.93) | 0.983 (0.706–1.370) | 0.982 (0.690–1.396) |
WHO 2.0 level | 116 (4.5%) | 62 (9.48%) | 2221.87 | 2193.60 (133.81) | 53.56 (11.83) | 2.004 (1.308–3.071) | 1.668 (1.045–2.663) |
Odd ratio (95% CI) | |||
---|---|---|---|
Univariate | Multivariate | ||
PM2.5 WHO standard level (reference: normal level) | |||
WHO 1.0 level | 0.818 (0.595–1.126) | 0.825 (0.588–1.158) | |
WHO 1.5 level | 0.983 (0.706–1.370) | 0.982 (0.690–1.396) | |
WHO 2.0 level | 2.004 (1.308–3.071) | 1.668 (1.045–2.663) | |
Gender (reference: female) | |||
Male | 1.000 (0.841–1.189) | 1.093 (0.911–1.311) | |
Age (reference:general population) | |||
Per year | 0.998 (0.983–1.013) | 0.999 (0.982–1.015) | |
Low income (reference: no) | |||
yes | 1.000 (0.837–1.195) | 0.744 (0.603–0.919) | |
Urbanization level (reference: highly urbanized) | |||
Moderate urbanization | 0.767 (0.609–0.967) | 0.822 (0.642–1.053) | |
Emerging town | 0.559 (0.418–0.747) | 0.640 (0.469–0.872) | |
General town | 0.611 (0.468–0.796) | 0.628 (0.464–0.852) | |
Aged Township | 0.591 (0.360–0.972) | 0.545 (0.320–0.927) | |
Agricultural town | 0.540 (0.366–0.794) | 0.471 (0.307–0.723) | |
Remote township | 0.436 (0.278–0.685) | 0.413 (0.254–0.669) | |
Comorbidity (reference: no) | |||
Hypertension | 1.366 (1.135–1.645) | 1.074 (0.873–1.320) | |
Ischemic heart disease | 1.378 (1.116–1.700) | 1.090 (0.865–1.374) | |
Hyperlipidemia | 1.824 (1.532–2.172) | 1.588 (1.305–1.932) | |
Congestive heart failure | 1.231 (0.939–1.613) | 1.015 (0.752–1.371) | |
Peripheral vascular disease | 1.708 (1.304–2.236) | 1.393 (0.998–1.943) | |
Atrial fibrillation | 2.188 (1.430–3.347) | 2.088 (1.324–3.292) | |
Ischemic stroke | 0.891 (0.538–1.476) | 0.796 (0.471–1.347) | |
Headaches | 1.319 (1.064–1.635) | 1.204 (0.954–1.519) | |
Migraines | 1.573 (1.016–2.437) | 1.417 (0.891–2.253) | |
Epilepsy and recurrent | 1.576 (0.879–2.827) | 1.635 (0.891–3.002) | |
Dementia | 1.019 (0.723–1.435) | 0.902 (0.625–1.301) | |
Rheumatoid arthritis | 1.177 (0.741–1.871) | 1.031 (0.635–1.675) | |
Systemic lupus erythematosus | 2.672 (0.446–16.023) | 3.126 (0.468–20.892) | |
Diabetes | 1.481 (1.232–1.779) | 1.175 (0.958–1.440) | |
Asthma | 1.047 (0.857–1.279) | 0.934 (0.755–1.155) | |
Chronic kidney disease | 1.203 (0.832–1.739) | 0.943 (0.638–1.394) | |
Hepatitis B | 1.235 (0.643–2.373) | 0.993 (0.502–1.963) | |
Fluid, Electrolyte, Acid–Base Disorders | 1.698 (1.035–2.784) | 1.455 (0.866–2.446) | |
Tuberculosis | 1.016 (0.583–1.771) | 1.004 (0.562–1.793) | |
Anemia | 1.581 (1.236–2.021) | 1.410 (1.085–1.833) | |
Peptic ulcer | 1.616 (1.199–2.178) | 1.577 (1.157–2.149) | |
Depression | 1.237 (0.701–2.180) | 1.025 (0.568–1.850) | |
Malignant disease | 1.424 (1.120–1.811) | 1.280 (0.995–1.646) |
Odd Ratio (95% CI), Reference: Normal Level | Ptrend | |||
---|---|---|---|---|
WHO 1.0 level | WHO 1.5 level | WHO 2.0 level | ||
Total | 0.825 (0.588–1.158) | 0.982 (0.690–1.396) | 1.668 (1.045–2.663) | 0.0068 |
Hyperlipidemia | ||||
Yes | 0.678 (0.419–1.097) | 0.876 (0.532–1.441) | 1.291 (0.661–2.521) | 0.1567 |
No | 0.999 (0.609–1.639) | 1.122 (0.670–1.880) | 2.148 (1.100–4.194) | 0.0231 |
Atrial fibrillation | ||||
Yes | 0.474 (0.025–8.961) | 2.163 (0.108–43.256) | 0.196 (0.004–9.417) | 0.9929 |
No | 0.818 (0.58–1.155) | 0.957 (0.67–1.369) | 1.673 (1.037–2.699) | 0.0120 |
Anemia | ||||
Yes | 0.640 (0.262–1.566) | 0.559 (0.210–1.489) | 0.843 (0.223–3.193) | 0.5377 |
No | 0.828 (0.571–1.202) | 1.021 (0.695–1.500) | 1.814 (1.092–3.012) | 0.0062 |
Peptic ulcer | ||||
Yes | 0.877 (0.243–3.166) | 0.777 (0.214–2.814) | 5.602 (0.597–52.587) | 0.6761 |
No | 0.832 (0.581–1.191) | 1.014 (0.698–1.471) | 1.651 (1.012–2.692) | 0.0028 |
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Sun, H.-Y.; Luo, C.-W.; Chiang, Y.-W.; Li, K.-L.Y.Y.-C.; Ho, Y.-C.; Lee, S.-S.; Chen, W.-Y.; Chen, C.-J.; Kuan, Y.-H. Association Between PM2.5 Exposure Level and Primary Open-Angle Glaucoma in Taiwanese Adults: A Nested Case–control Study. Int. J. Environ. Res. Public Health 2021, 18, 1714. https://doi.org/10.3390/ijerph18041714
Sun H-Y, Luo C-W, Chiang Y-W, Li K-LYY-C, Ho Y-C, Lee S-S, Chen W-Y, Chen C-J, Kuan Y-H. Association Between PM2.5 Exposure Level and Primary Open-Angle Glaucoma in Taiwanese Adults: A Nested Case–control Study. International Journal of Environmental Research and Public Health. 2021; 18(4):1714. https://doi.org/10.3390/ijerph18041714
Chicago/Turabian StyleSun, Han-Yin, Ci-Wen Luo, Yun-Wei Chiang, Kun-Lin Yeh Yi-Ching Li, Yung-Chung Ho, Shiuan-Shinn Lee, Wen-Ying Chen, Chun-Jung Chen, and Yu-Hsiang Kuan. 2021. "Association Between PM2.5 Exposure Level and Primary Open-Angle Glaucoma in Taiwanese Adults: A Nested Case–control Study" International Journal of Environmental Research and Public Health 18, no. 4: 1714. https://doi.org/10.3390/ijerph18041714