The Relationship Between Metabolic Syndrome And Age-related Cataract

ObjectiveThe objective of the present study is to investigate the status ofepidemiology of surgically treated age-related cataract (ARC) and to explore theassociation between metabolic syndrome (hypertension, hyperlipidemia,diabetes and obesity), socio-demographic characteristics, lifestyle habits,personal medical history, and development of ARC in middle aged and elderlymen.MethodsA hospital-based case control study was conducted from April2010toAugust2011. A total of360cases aged45~85years old for cataract extractionand360frequency-matched controls in the same hospital for various acute,non-neoplastic, non-metabolic diseases were included in the study. All subjectswere interviewed using a structured interviewer-administrated questionnaire,covering socio-demographic characteristics, lifestyle habits, detailed medicalhistory and laboratory examination. Body mass index (BMI) and waist to hip ratio(WHR) were calculated simultaneously. Cases were medically diagnosed andclassified from slitlamp and retroillumination photographs using lens opacitiesclassification system III. Analyses were conducted using SPSS13.0. The oddsratios (OR) and corresponding95%confidence intervals (CI) of ARC werecomputed from multiple logistic regression models.Results1. In total,360cases and360frequency-matched controls aged45~85,were included in the study. The mean age of cases and controls was69.20±10.39and69.62±10.93. The most frequent type of cataract was cortical (n =190) followed by nuclear (n=107) and posterior subcapsular cataract (n=63).2. After adjusted for age and gender, hypertension was significant positivelyrelated with ARC (OR=1.573, P=0.005). Compared with normal systolic bloodpressure, systolic blood pressure≥180mmHg increase the risk of onset (OR=2.812,95%CI:1.450~5.455, P=0.002). The duration of hypertension wasassociated with an increased risk of ARC, especially those men for10to20years (OR=1.867,95%CI:1.053~3.307, P=0.033).3. After adjusting for multiple potential confounders, in multivariate Logisticregression analysis, fasting glucose impaired was positively related with ARC(OR=1.734,95%CI:1.102~2.725, P <0.001), the cases of diabetes have alarger risk than controls (OR=1.938,95%CI:1.293~2.906, P=0.001). Diabetesduration was also positively related with ARC, the risk of ARC in diabetesduration <10years and10to19years significantly increased (OR=2.374;95%CI:1.502~3.752, P <0.001and OR=2.683;95%CI:1.267~5.683, P=0.010respectively).4. After adjusted for age and gender, hyperlipidemia, hyperlipidemiaduration, TC, TG had no relation with the risk of ARC, though declining level ofthe HDL-C were associated with higher risk of ARC (OR=1.519,95%CI:1.093~2.110, P=0.013).5. The number of ARC patients with diabetes mellitus, hypertension orcentral obesity is more than controls. The patients with metabolic syndrome aremore than controls, and compared with controls, cases with more components ofmetabolic syndrome have a larger proportion. After adjusting for multiplepotential confounders, diabetes, hypertension, low high densitylipoprotein-cholesterol, high triglyceride levels, and central obesity werepositively associated with ARC. Among cases with metabolic syndrome, the riskof ARC was approximately2-fold more than controls without metabolicsyndrome (OR=2.213,95%CI:1.012~4.837; P=0.023). Cases with at least3components of the metabolic syndrome had a significantly increased risk of ARC(OR=2.667,95%CI:1.166~6.097; P=0.014) compared with controls withoutany of these components. The risk of ARC increased with more components ofmetabolic syndrome, and the linear trend test was statistical significance (P <0.001).Conclusions1. The duration of diastolic blood pressure, hypertension and diabetes mayincrease the prevalence rate of ARC.2. This study indicates that the HDL-C to be associated with an increasedrisk for ARC.3. This study indicates that the metabolic syndrome, its components, andtheir combination seem to be associated with an increased risk for ARC.