Metabolic syndrome components in relation to risk of cataract extraction: a prospective cohort study of women

The epidemiology of cataract: a study in Greece

PURPOSE

We conducted a case-control study to identify risk factors for cataract in the Mediterranean Greek population. Three hundred and fourteen cases and 314 frequency-matched controls of both genders, aged 45-85, attending the ophthalmology department of a major teaching hospital in Athens, Greece, were included in the study.

METHODS

Cases were medically diagnosed and classified. Controls were healthy visitors without cataract. A detailed questionnaire, covering demographic, socioeconomic, somatometric, lifestyle and medical history variables, provided data on possible risk factors for cataract. Analyses were conducted through multiple logistic regression.

MAIN OUTCOME MEASURES

Cataract overall and by type: nuclear, cortical and posterior subcapsular (PSC).

RESULTS

  Statistically significant increased risk for cataract overall was found for current (OR = 1.99, 95%CI: 1.23-3.23) and ex-smokers (OR = 1.64, 95%CI: 1.02-2.70), history of coronary heart disease (OR = 2.25, 95%CI: 1.43-3.55), family history of ophthalmologic diseases (OR = 1.51, 95%CI: 1.03-2.20) and higher sunlight exposure at the beach (OR = 2.26, 95%CI: 1.37-3.72) as well as at work (OR = 2.03, 95%CI: 1.32-3.12). Use of measures protecting against sunlight at the beach, i.e. hat (OR = 0.58, 95%CI: 0.39-0.85) and vision repair spectacles (OR = 0.44, 95% CI: 0.30-0.65), were associated with reduced risk. RESULTS for cataract overall were also evident for the nuclear type and in most circumstances for PSC type, but were only suggestive for the cortical type of cataract.

CONCLUSION

We identified certain possible risk factors for age-related cataract. In a Mediterranean Greek population, we found that smoking, use of cortisone drops, cardiovascular heart disease and sunlight exposure increase the risk for cataract, while use of hat and vision repair spectacles act protectively.

Metabolic syndrome, its components and risk of age-related cataract extraction: a case-control study in Italy

PURPOSE

We sought to explore the relationship between age-related cataract extraction and the metabolic syndrome or its various components separately and in various combinations in an Italian case-control study.

METHODS

A total of 761 cases and 1,522 controls in hospital for acute, non-neoplastic, non-ophthalmologic, non-metabolic diseases were interviewed between 1991 and 2003. Odds ratios (ORs), and their 95% confidence intervals (CIs), were computed from multiple logistic regression models, conditioned on sex, age, and study center and adjusted for education and smoking.

RESULTS

The ORs were 1.41 for a history of central obesity, 1.42 for hypertension, 1.25 for hyperlipidemia, and 1.16 for diabetes. Patients with the metabolic syndrome (defined as the simultaneous presence of central obesity and at least two other factors among hypertension, hyperlipidemia, diabetes) had an increased risk of cataract, with an OR of 2.01 (95% CI: 1.43-2.83). The ORs were 1.75 for the presence of any of two components and 2.50 for three to four components, with a linear trend in risk.

CONCLUSIONS

This study indicates that the metabolic syndrome, its components, and their combination are associated with an increased risk of cataract extraction in this Italian population.

Is cataract associated with cardiovascular morbidity?

AIMS

To evaluate the prevalence of cardiovascular disease (CVD) and its risk factors among patients undergoing cataract surgery.

METHODS

A retrospective observational case-control study of all the members older than 50 years who underwent cataract surgery in the Central District of Clalit Health Services in Israel (years 2000-2007) (n=12,984) and 25, 968 age- and gender-matched controls. We calculated the prevalence of CVDs' and their risk factors, including carotid artery disease (CAD), peripheral vascular disease (PVD), systemic arterial hypertension (HTN), chronic renal failure (CRF), ischaemic heart disease (IHD), congestive heart failure, diabetes, smoking, alcohol abuse, and hyperlipidaemia. The main outcome measures were the odds ratio of having CVDs among cataract patients undergoing surgery compared with controls.

RESULTS

No difference was found in demographics (age, gender, marriage status, socioeconomic class, and living place) between the study and control groups. All CVDs' risk factors were significantly more prevalent in cataract patients in univariate analysis. Multivariate logistic regression analysis revealed a significant association of the following with cataractogenesis: diabetes, CAD, HTN, PVD, smoking, IHD, CRF, hyperlipidaemia, and Ashkenazi origin.

CONCLUSIONS

CVDs and their risk factors are more prevalent among cataract patients undergoing cataract surgery.

Obesity, metabolic syndrome, and the surgical patient

Contemporary life, with its sedentary lifestyles, fast foods, processed foodstuff, and desk-bound service employment, is beset by an epidemic of overweight and obese individuals. The World Health Organization reported that worldwide a billion adults are overweight and at least 30% of them are obese. Moreover, increasing numbers of children are obese. In the United States, 2 National Health and Nutrition Examination Surveys of adults aged 20 to 74 years showed that the prevalence of obesity increased from 15% in the 1976 to 1980 survey to 34% in the 2003 to 2004 survey. Obesity and the metabolic syndrome are unfortunately becoming increasingly common perioperative issues. The ultimate aim of caring for such patients is to find ways to minimize the untoward effects of surgery in patients who are obese or have metabolic syndrome.

Obesity, metabolic syndrome, and the surgical patient

Contemporary life, with its sedentary lifestyles, fast foods, processed foodstuff, and desk-bound service employment, is beset by an epidemic of overweight and obese individuals. The World Health Organization reported that worldwide a billion adults are overweight and at least 30% of them are obese. Moreover, increasing numbers of children are obese. In the United States, 2 National Health and Nutrition Examination Surveys of adults aged 20 to 74 years showed that the prevalence of obesity increased from 15% in the 1976 to 1980 survey to 34% in the 2003 to 2004 survey. Obesity and the metabolic syndrome are unfortunately becoming increasingly common perioperative issues. The ultimate aim of caring for such patients is to find ways to minimize the untoward effects of surgery in patients who are obese or have metabolic syndrome.