Analysis of the Impact of Multiple Chronic Diseases on the Risk of Age-related Macular Degeneration and Their Interaction Effects
摘要
Background Age-related macular degeneration (AMD) is the leading cause of vision loss and impairment among individuals aged 50 and above worldwide, with an estimated 288 million people projected to be affected by 2040. Objective To investigate the association between various chronic diseases and AMD, analyze the interaction effects of different chronic disease combinations on AMD risk, and assess how the interaction between chronic diseases impacts AMD risk. Methods Based on the Cheeloo LEAD database, individuals aged 50 years and above were included. The AMD group was identified using ICD-10 coding (H35.3), and a 1∶4 matching by age and gender was conducted to select control group without AMD. Significant differences in baseline characteristics and chronic disease prevalence were found between the AMD and non-AMD groups. Multivariate Logistic regression models were used to assess the association between AMD and chronic conditions such as hypertension, diabetes, and heart disease. Collinearity was evaluated using the variance inflation factor (VIF) to ensure the robustness of the model. Interaction terms were introduced to evaluate the synergistic effects of different chronic disease combinations on AMD risk. Results A total of 16 780 participants were included in this study, with 3 356 in the AMD group and 13 424 in the control group. After adjusting for confounding factors, multivariate Logistic regression analysis showed that hypertension (OR=2.81, 95%CI=2.59-3.04), heart disease (OR=2.02, 95%CI=1.86-2.19), stroke (OR=1.82, 95%CI=1.66-1.99), diabetes (OR=2.72, 95%CI=2.47-2.99), dyslipidemia (OR=2.01, 95%CI=1.78-2.28), chronic gastric or digestive system diseases (OR=1.90, 95%CI=1.72-2.10), chronic liver diseases (OR=2.29, 95%CI=2.04-2.57), emotional and mental disorders (OR=2.86, 95%CI=2.49-3.29), and memory-related diseases (OR=1.86, 95%CI=1.52-2.28) were all significant risk factors for AMD (P<0.05). Interaction effect analysis revealed that the predicted pr