上明眼科診所

醫學新知

2011-10-01

眼瞼脂肪瘤



『眼瞼脂肪瘤』的出現不論血液中脂肪是否異常都增加缺血性心臟病或中風的機會應積極降低血脂肪來應對
根據最新九月份英國醫學期刊(British Medical Journal)依據哥本哈根市心臟研究(Copenhagen City Heart Study.33期間共12 745人追蹤得到結論。
 
For the current analysis, researchers followed 12 745 people aged 20–93 years free of ischemic vascular disease at baseline from 1976–1978 until May 2009 as part of the Copenhagen City Heart Study.
Results showed that 563 (4.4%) of participants had xanthelasmata, and these patients had an increased risk of myocardial infarction, ischemic heart disease, severe atherosclerosis, and death compared with individuals without xanthelasmata over the 33-year follow-up period.
The study, published online September 16 in the British Medical Journal
Study Highlights
  • The goal of this prospective, population-based cohort study was to test the hypothesis that xanthelasmata and arcus corneae, individually and combined, would predict the risks for ischemic vascular disease and death in the general population.
  • The study cohort consisted of 12,745 white participants in the Copenhagen City Heart Study. The participants were 20 to 93 years old and were free of ischemic vascular disease at baseline.
  • Follow-up was for 33 years, from 1976 to 1978 until May 2009, with a follow-up rate of 100%. Mean duration of follow-up was 22 years.
  • The primary study endpoints were multifactorially adjusted HRs for myocardial infarction, ischemic heart disease, ischemic stroke, ischemic cerebrovascular disease, and death, and odds ratios (ORs) for severe atherosclerosis.
  • At baseline, 563 (4.4%) of participants had xanthelasmata, and 3159 (24.8%) had arcus corneae.
  • During follow-up, myocardial infarction occurred in 1872 participants, ischemic heart disease in 3699, ischemic stroke in 1498, and ischemic cerebrovascular disease in 1815 participants; 8507 participants died.
  • For people with vs those without xanthelasmata, the multifactorially adjusted HRs were 1.48 (95% confidence interval [CI], 1.23 - 1.79) for myocardial infarction, 1.39 (95% CI, 1.20 - 1.60) for ischemic heart disease, 0.94 (95% CI, 0.73 - 1.21) for ischemic stroke, 0.91 (95% CI, 0.72 - 1.15) for ischemic cerebrovascular disease, 1.69 (95% CI, 1.03 - 2.79) for severe atherosclerosis, and 1.14 (95% CI, 1.04 - 1.26) for death.
  • For people with vs those without arcus corneae, the corresponding HRs were nonsignificant.
  • For people with vs those without both xanthelasmata and arcus corneae, multifactorially adjusted HRs were 1.47 (95% CI, 1.09 - 1.99) for myocardial infarction, 1.56 (95% CI, 1.25 - 1.94) for ischemic heart disease, 0.87 (95% CI, 0.57 - 1.31) for ischemic stroke, 0.86 (95% CI, 0.58 - 1.26) for ischemic cerebrovascular disease, 2.75 (95% CI, 0.75 - 10.1) for severe atherosclerosis, and 1.09 (95% CI, 0.93 - 1.28) for death.
  • The presence of xanthelasmata was associated with an increased absolute 10-year risk for myocardial infarction, ischemic heart disease, and death in all age groups in both women and men.
  • Men 70 to 79 years old with and without xanthelasmata had the highest absolute 10-year risks for ischemic heart disease of 53% and 41%, respectively.
  • In women, the corresponding values were 35% and 27%.
  • On the basis of these findings, the investigators concluded that xanthelasmata predicts the risks for myocardial infarction, ischemic heart disease, severe atherosclerosis, and death in the general population, independently of plasma cholesterol and triglyceride levels and other well-known cardiovascular risk factors.
  • However, the presence of arcus corneae was not associated with increased risk.
  • The presence of xanthelasmata could help clinicians to diagnose ischemic cardiovascular disease, particularly in societies with limited access to laboratory facilities and lipid profile measurement.
  • An accompanying editorial emphasizes the importance of a comprehensive physical examination and suggests that xanthelasmata could be used by general clinicians to help identify people at higher risk for cardiovascular disease.
  • Limitations of this study include lack of generalizability to nonwhite populations, diagnosis of xanthelasmata and arcus corneae based on visual inspection, and possible unmeasured confounders.
Clinical Implications
  • In a prospective, population-based cohort study, xanthelasmata were associated with the risks for myocardial infarction, ischemic heart disease, severe atherosclerosis, and death, independently of plasma cholesterol and triglyceride levels and other well-known cardiovascular risk factors.
  • However, the presence of arcus corneae was not associated with an increased risk for ischemic disease or death in this study.