Dataset Information

Prevalence of refractive error in the United States, 1999-2004.

ABSTRACT: OBJECTIVE:To describe the prevalence of refractive error in the United States. METHODS:The 1999-2004 National Health and Nutrition Examination Survey (NHANES) used an autorefractor to obtain refractive error data on a nationally representative sample of the US noninstitutionalized, civilian population 12 years and older. Using data from the eye with a greater absolute spherical equivalent (SphEq) value, we defined clinically important refractive error as follows: hyperopia, SphEq value of 3.0 diopters (D) or greater; myopia, SphEq value of -1.0 D or less; and astigmatism, cylinder of 1.0 D or greater in either eye. RESULTS:Of 14,213 participants 20 years or older who completed the NHANES, refractive error data were obtained for 12,010 (84.5%). The age-standardized prevalences of hyperopia, myopia, and astigmatism were 3.6% (95% confidence interval [CI], 3.2%-4.0%), 33.1% (95% CI, 31.5%-34.7%), and 36.2% (95% CI, 34.9%-37.5%), respectively. Myopia was more prevalent in women (39.9%) than in men (32.6%) (P < .001) among 20- to 39-year-old participants. Persons 60 years or older were less likely to have myopia and more likely to have hyperopia and/or astigmatism than younger persons. Myopia was more common in non-Hispanic whites (35.2%) than in non-Hispanic blacks (28.6%) or Mexican Americans (25.1%) (P < .001 for both). CONCLUSION:Estimates based on the 1999-2004 NHANES vision examination data indicate that clinically important refractive error affects half of the US population 20 years or older.

SUBMITTER: Vitale S

PROVIDER: S-EPMC2772054 | biostudies-literature | 2008 Aug

REPOSITORIES: biostudies-literature

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Prevalence of refractive error in the United States, 1999-2004.

Vitale Susan S Ellwein Leon L Cotch Mary Frances MF Ferris Frederick L FL Sperduto Robert R

Archives of ophthalmology (Chicago, Ill. : 1960) 20080801 8

<h4>Objective</h4>To describe the prevalence of refractive error in the United States.<h4>Methods</h4>The 1999-2004 National Health and Nutrition Examination Survey (NHANES) used an autorefractor to obtain refractive error data on a nationally representative sample of the US noninstitutionalized, civilian population 12 years and older. Using data from the eye with a greater absolute spherical equivalent (SphEq) value, we defined clinically important refractive error as follows: hyperopia, SphEq ...[more]

PMID: 18695106

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Project description:BACKGROUND:Clinical reports link specific medications with the development of antinuclear antibodies (ANA), but population-based evidence is limited. OBJECTIVE:The present study investigated associations between prescription medication use and ANA in a representative sample of the adult noninstitutionalized US population, first focusing on medications previously related to ANA and then considering all medications reported in the National Health and Nutrition Examination Survey (NHANES). METHODS:Based on NHANES data (1999-2004) for 3608 adults (ages ?18 years), we estimated odds ratios (ORs) and 95% confidence intervals (CIs) to assess associations between recent medication use and ANA (overall and in sex and age subgroups), adjusted for potential confounders and the survey sampling design. RESULTS:We found no evidence that most medications previously associated with ANA in specific individuals were risk factors for ANA in the general population, although statistical power was limited for some medications. Overall, ANA were less prevalent in adults who recently used any prescription medications compared with those who did not (OR?=?0.73; CI?=?0.57,0.93), and likewise several classes of medications were inversely associated with ANA, including hormones (OR?=?0.73; CI?=?0.55,0.98), thiazide diuretics (OR?=?0.43; CI?=?0.24,0.79), sulfonylureas (OR?=?0.41; CI?=?0.19,0.89), and selective serotonin reuptake inhibitor antidepressants (OR?=?0.65; CI?=?0.42,0.98). Positive associations with ANA were seen for loop diuretics (OR?=?1.72; CI?=?1.03,2.88) in all adults, and for benzodiazepines (OR?=?2.11; CI?=?1.09,4.10) and bronchodilators (OR?=?1.83; CI?=?1.00,3.38) in older (ages ?60) adults. Estrogens were positively associated with ANA in older women (OR?=?1.80; CI?=?1.00,3.23) but inversely associated with ANA in younger (ages 18-59) women (OR?=?0.43; CI?=?0.20,0.93). Regarding individual medications, ANA were positively associated with ciprofloxacin (OR?=?4.23; CI?=?1.21,14.8), furosemide (OR?=?1.79; CI?=?1.09,2.93), and omeprazole (OR?=?2.05; CI?=?1.03,4.10) in all adults, and with salmeterol (OR?=?3.76; CI?=?1.66,8.52), tolterodine (OR?=?6.64; CI?=?1.45,30.5), and triamterene (OR?=?3.10; CI?=?1.08,8.88) in older adults. Also, in younger adults, hydrochlorothiazide was inversely associated with ANA (OR?=?0.44; CI?=?0.20,0.98). CONCLUSIONS:Our findings in the general population do not confirm most clinically reported positive associations between specific medications and ANA in some individuals. However, novel positive ANA associations with other medications, as well as unexplained inverse associations with certain classes of medications and overall medication use, deserve further research to clarify the possible roles of medications as risk and protective factors in the development of autoantibodies and autoimmune disease.

Project description:Estimates of chronic kidney disease (CKD) in the United States using the continuous National Health and Nutrition Examination Survey (NHANES) data set 1999-2004 indicate that 13.1% of the population (26.3 million people based on the 2000 census) has CKD stages 1 to 4.We performed sensitivity analyses to highlight assumptions underlying these estimates and illustrate their robustness to varying assumptions.NHANES 1999-2004 was a nationally representative cross-sectional continuous survey of the civilian noninstitutionalized US population. Our sample included participants 20 years and older.Estimated glomerular filtration rate (GFR) less than 60 mL/min/1.73 m(2) defined from the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation; albuminuria defined as persistence of urinary albumin-creatinine ratio greater than 30 mg/g.We compared prevalence estimates using the MDRD Study equation with 2 other GFR estimating equations (equation 5 by Rule et al from the Mayo Clinic Donors study; Cockcroft-Gault equation adjusted for body surface area and corrected for the bias in the MDRD Study sample), and sex-specific cutoff values to define albuminuria.We found CKD stages 1 to 4 prevalence estimates ranging from 11.7% to 24.9%, a more than 2-fold difference resulting in population estimates of 25.8 million to 54.0 million people using 2006 population estimates. Considering only stages 3 and 4, which are not affected by the choice of cutoff values to define albuminuria, prevalence estimates ranged from 6.3% to 18.6%, resulting in population estimates of 13.7 million to 40.3 million people, a nearly 3-fold difference.NHANES 1999-2004 is a cross-sectional survey and allows for GFR and albumin-creatinine ratio estimates at 1 point in time. NHANES does not account for seniors in long-term care facilities.Although CKD prevalence is high regardless of varying modeling assumptions, different assumptions yield large differences in prevalence estimates.

Dataset Information

Prevalence of refractive error in the United States, 1999-2004.

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Prevalence of refractive error in the United States, 1999-2004.

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