한빛사논문
- 조회373
Su Hwan Kim, PhD1; Young Kook Kim, MD, PhD2,3,4; Young In Shin, MD2,3; Goneui Kang, MS4; Seong Pyo Kim, MS5; Hajoung Lee, PhD4; In Hwan Hong, MD, PhD6,7; In Boem Chang, MD, PhD8; Soon-Beom Hong, MD, PhD9,10,11; Hyung-Jin Yoon, MD, PhD12; Ahnul Ha, MD3,13,14
1Biomedical Research Institute, Seoul National University Hospital (SNUH), Seoul, Korea
2Department of Ophthalmology, SNUH, Seoul, Korea
3Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
4EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul, Korea
5Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, Korea
6Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hwaseong, Korea
7Department of Ophthalmology, Hallym University Medical Center, Hwaseong, Korea
8Seoul ON Eye Clinic, Seoul, Korea
9Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
10Department of Psychiatry, SNUH, Seoul, Korea
11Institute of Human Behavioral Medicine, SNU Medical Research Center, Seoul, Korea
12Medical Bigdata Research Center, SNU College of Medicine, Seoul, Korea
13Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
14Department of Ophthalmology, Jeju National University College of Medicine, Jeju, Korea
Drs S. H. Kim and Y. K. Kim contributed equally to the study as co–first authors.
Corresponding Author: Ahnul Ha, MD, Hyung-Jin Yoon, MD, PhD
Abstract
Importance: Light pollution's impact on human health is increasingly recognized, but its link to exudative age-related macular degeneration (EAMD) remains unclear.
Objective: To investigate the association between exposure to outdoor artificial light at night (OALAN) and the risk of incident EAMD.
Design, setting, and participants: In this nationwide population-based case-control study, all individuals 50 years or older with newly diagnosed EAMD between January 1, 2010, and December 31, 2011, were identified with reference to the Korean National Health Insurance Service registration program database for rare and intractable diseases. Birth year- and sex-matched controls (with no EAMD diagnosis until 2020) were selected at a 1:30 ratio. Data were acquired from May 1 to December 31, 2021, and analyzed from June 1 to November 30, 2022.
Exposures: Mean levels of OALAN at participants' residential addresses during 2008 and 2009 were estimated using time-varying satellite data for a composite view of persistent nighttime illumination at an approximate scale of 1 km2.
Main outcomes and measures: The hazard ratios (HRs) and 95% CIs of the association between residential OALAN and risk of incident EAMD were determined based on maximum likelihood estimation after adjusting for sociodemographic characteristics, comorbidities, and area-level risk factors (ie, nighttime traffic noise and particulate matter of aerodynamic diameter ≤10 μm in each participant's administrative district of residence).
Results: A total of 126 418 participants were included in the analysis (mean [SD] age, 66.0 [7.9] years; 78 244 men [61.9%]). Of these, 4078 were patients with newly diagnosed EAMD and 122 340 were EAMD-free matched controls. In fully adjusted models, an IQR (55.8 nW/cm2/sr) increase in OALAN level was associated with an HR of 1.67 (95% CI, 1.56-1.78) for incident EAMD. The exposure-response curve demonstrated a nonlinear, concave upward slope becoming more pronounced at higher levels of light exposure (ie, at approximately 110 nW/cm2/sr). In a subgroup analysis, an IQR increase in OALAN was associated with increased risk of incident EAMD in urban areas (HR, 1.46 [95% CI, 1.33-1.61]) but not in rural areas (HR, 1.01 [95% CI, 0.84-1.22]).
Conclusions and relevance: In this nationwide population-based case-control study, higher levels of residential OALAN were associated with an increased risk of incident EAMD. Future studies with more detailed information on exposure, individual adaptive behaviors, and potential mediators are warranted.
논문정보
- Research article
- 2024년 01월 (BRIC 등록일 2024-01-17)
- 국내 연구진
- 의약학 > 응용의학
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