Anthropometric status and cataract: the Salisbury Eye Evaluation project

Abstract

Background: Weight or body mass index (BMI; in kg/m 2 ) is frequently identified as a risk factor for cataract, but the nature of the association is unclear. Objective: We aimed to characterize the relation between BMI and stature and risk of different types of cataract. Design: We analyzed data from participants in the Salisbury Eye Evaluation (SEE), a cross-sectional survey of visual status and demographic, nutritional, and environmental factors conducted between 1993 and 1995 in a representative sample of community-dwelling older persons in Salisbury, MD. Multiple logistic regression techniques were used to compare risk factors between individuals with nuclear, cortical, or posterior subcapsular (PSC) opacities and individuals with no cataract. Results: Risk of nuclear opacification was greater in participants with lower BMIs [adjusted odds ratio of 1.13 (95% CI: 1.02, 1.27) with a BMI of 22.5 compared with 28.0] and of taller stature [1.12 (95% CI: 1.01, 1.25) with a stature of 170.5 cm compared with 164]. In contrast, risk of cortical opacification was greater in participants with higher BMIs and of taller stature, but the relation for stature diminished in magnitude and was not significant after adjustment for other risk factors. BMI was not related to risk of PSC opacities, but there was some evidence that taller stature is a risk factor for PSC opacification (P = 0.06) after adjustment for other risk factors. Conclusions: Both BMI and stature are independent risk factors for cataracts in the SEE population, with the nature of the risk dependent on cataract type.Am J Clin Nutr 1999;69:237-42. KEY WORDSBody mass index, BMI, stature, weight, elderly, cataract, Salisbury Eye Evaluation, posterior subcapsular opacity INTRODUCTIONCataract is the leading cause of blindness worldwide (1). As many as 50% of Americans > 65 y of age have some type of cataract, and their removal is the principal reason for surgery in older Americans (2). Thus, the identification of modifiable risk factors for cataract formation is a national public health priority (3).Previous research has identified many risk factors for agerelated cataract, including injury, environment, disease, and nutrition-related factors (4,5). In various studies, cataract risk has been shown to increase with older age, race, diabetes, hypertension, smoking, alcohol use, and low socioeconomic status or educational attainment. Variation in body mass index (BMI; in kg/m 2 ) has also been shown to influence cataract risk, although there is no consensus on the direction or nature of the association. Both higher (6) and lower (7-10) BMIs have been associated with increased risk of cataract. It is difficult to conclude much about the role of BMI in cataract formation for several reasons. First, lower BMIs are associated with smoking, alcohol consumption, and lower socioeconomic status, whereas higher BMIs are associated with African American race, diabetes, hypertension, and other morbidities, all of which also influence risk of cataract. Second, the etiolo...

Association Between Cataract and the Degree of Obesity

“…Several previous studies 5,6,17,26 using population data showed a relatively higher prevalence (2.7 to 12.1%) of PSC cataract compared to our result: 0.5% in men and 0.8% in women. Insufficient numbers of patients with PSC cataract might cause the nonsignificant results in these data, although the consistent association between PSC cataract and obesity was proposed in a review study.…”

Association Between Cataract and the Degree of Obesity

“…Several previous studies 5,6,17,26 using population data showed a relatively higher prevalence (2.7 to 12.1%) of PSC cataract compared to our result: 0.5% in men and 0.8% in women. Insufficient numbers of patients with PSC cataract might cause the nonsignificant results in these data, although the consistent association between PSC cataract and obesity was proposed in a review study.…”

Risk factors for cataract subtypes waterclefts and retrodots: two case–control studies

“…Those with intermediate BMI had almost half the risk (OR ¼ 0.52) of those subjects with a lower BMI of less than 22. Our finding is comparable with that of the Blue Mountains Eye Study 23 for cortical and PSC cataract, the Boston Nurses' Health Study cohort 24 for posterior subcapsular opacities, the Salisbury Eye Evaluation (SEE) project 25 for cortical opacity only with opposite effect for nuclear opacity, and the Framingham Eye Study cohort 26 for incident cortical and posterior subcapsular opacities.…”

Hormone Replacement Therapy and Lens Opacities

“…Also, because estrogen may be stored in fat, the association of lower prevalence of nuclear opacity with a BMI of 25 to 30 (OR, 0.5; 95% CI, 0.4-0.7) or of greater than or equal to 30 (OR, 0.4; 95% CI, 0.3-0.6) compared with a BMI of less than 25 was of interest. This association was found previously by Caulfield et al 12 In addition, an increasing number of births was associated with a lower prevalence of nuclear opacity (test of trend, P=.003). However, this association differed by age cohort.…”

Association Between Cataract and the Degree of Obesity

“…Several previous studies 5,6,17,26 using population data showed a relatively higher prevalence (2.7 to 12.1%) of PSC cataract compared to our result: 0.5% in men and 0.8% in women. Insufficient numbers of patients with PSC cataract might cause the nonsignificant results in these data, although the consistent association between PSC cataract and obesity was proposed in a review study.…”

Risk factors for cataract subtypes waterclefts and retrodots: two case–control studies

“…Those with intermediate BMI had almost half the risk (OR ¼ 0.52) of those subjects with a lower BMI of less than 22. Our finding is comparable with that of the Blue Mountains Eye Study 23 for cortical and PSC cataract, the Boston Nurses' Health Study cohort 24 for posterior subcapsular opacities, the Salisbury Eye Evaluation (SEE) project 25 for cortical opacity only with opposite effect for nuclear opacity, and the Framingham Eye Study cohort 26 for incident cortical and posterior subcapsular opacities.…”

Hormone Replacement Therapy and Lens Opacities

“…Also, because estrogen may be stored in fat, the association of lower prevalence of nuclear opacity with a BMI of 25 to 30 (OR, 0.5; 95% CI, 0.4-0.7) or of greater than or equal to 30 (OR, 0.4; 95% CI, 0.3-0.6) compared with a BMI of less than 25 was of interest. This association was found previously by Caulfield et al 12 In addition, an increasing number of births was associated with a lower prevalence of nuclear opacity (test of trend, P=.003). However, this association differed by age cohort.…”

Association Between Cataract and the Degree of Obesity

“…Several previous studies 5,6,17,26 using population data showed a relatively higher prevalence (2.7 to 12.1%) of PSC cataract compared to our result: 0.5% in men and 0.8% in women. Insufficient numbers of patients with PSC cataract might cause the nonsignificant results in these data, although the consistent association between PSC cataract and obesity was proposed in a review study.…”

Risk factors for cataract subtypes waterclefts and retrodots: two case–control studies

“…Those with intermediate BMI had almost half the risk (OR ¼ 0.52) of those subjects with a lower BMI of less than 22. Our finding is comparable with that of the Blue Mountains Eye Study 23 for cortical and PSC cataract, the Boston Nurses' Health Study cohort 24 for posterior subcapsular opacities, the Salisbury Eye Evaluation (SEE) project 25 for cortical opacity only with opposite effect for nuclear opacity, and the Framingham Eye Study cohort 26 for incident cortical and posterior subcapsular opacities.…”

Hormone Replacement Therapy and Lens Opacities

“…Also, because estrogen may be stored in fat, the association of lower prevalence of nuclear opacity with a BMI of 25 to 30 (OR, 0.5; 95% CI, 0.4-0.7) or of greater than or equal to 30 (OR, 0.4; 95% CI, 0.3-0.6) compared with a BMI of less than 25 was of interest. This association was found previously by Caulfield et al 12 In addition, an increasing number of births was associated with a lower prevalence of nuclear opacity (test of trend, P=.003). However, this association differed by age cohort.…”