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Sozer O, Ozalp O, Atalay E, Demir SS, Alatas İO, Yildirim N. Comparison of blood levels of vitamin B12, folic acid, riboflavin, and homocysteine in keratoconus and healthy subjects. J Cataract Refract Surg 2023; 49:589-594. [PMID: 36745841 DOI: 10.1097/j.jcrs.0000000000001160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/30/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate blood levels of vitamin B12, folic acid, riboflavin, and homocysteine in keratoconus (KC) and healthy subjects. SETTING Eskişehir Osmangazi University, Eskişehir, Turkey. DESIGN Cross-sectional study. METHODS 100 KC patients (patient group) between the ages of 18 to 35 years and 200 healthy individuals (control group) in the same age range were included in the Eskişehir Osmangazi University Hospital Eye Clinic between October 2019 and March 2020. In all cases, a complete ophthalmologic examination and corneal tomography evaluation with a Pentacam Scheimpflug camera were performed. In blood samples, vitamin B12 and folic acid levels were measured using an electrochemiluminescence immunoassay analyzer, and homocysteine and riboflavin levels were measured using high-performance liquid chromatography. Chi-square tests were used in the analysis of categorical variables, and Mann-Whitney U and Kruskal-Wallis tests were used in the analysis of numerical variables. RESULTS Homocysteine (13.0 ± 6.6 vs 12.1 ± 5.4 μmol/L, P = .190), vitamin B12 (313.5 ± 119.4 vs 322.9 ± 128.3 pg/mL, P = .619), and folic acid (7.0 ± 2.7 vs 7.4 ± 2.9 ng/mL, P = .230) levels were not different between KC (100 eyes of 100 subjects) and control (200 eyes of 200 subjects) groups. The mean riboflavin level was 84.0 ± 21.8 μg/L in the patient group and 183.6 ± 74.3 μg/L in the control group, with a significant difference between the 2 groups ( P < .001). Riboflavin levels were below 180 μg/L in 99% (n = 99) of the cases in the KC group and 53.5% (n = 107) in the control group ( P < .001). CONCLUSIONS Low blood riboflavin levels in KC patients may be a possible risk factor in the pathogenesis of KC.
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Affiliation(s)
- Omer Sozer
- From the Ophthalmology Clinic, Emirdag State Hospital, Afyonkarahisar, Turkey (Sozer); Ophthalmology Clinic, Private Gürlife Hospital, Eskişehir, Turkey (Ozalp); Department of Ophthalmology, Eskişehir Osmangazi University Medical School, Eskişehir, Turkey (Atalay, Yildirim); Medical Biochemistry Clinic, Sandikli State Hospital, Afyonkarahisar, Turkey (Demir); Department of Medical Biochemistry, Eskişehir Osmangazi University Medical School, Eskişehir, Turkey (Alatas)
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Jesu Amalraj AJ, Wang SF. An effective morphology controlled hydrothermal synthesis of Bi2WO6 and its application in riboflavin electrochemical sensor. Colloids Surf A Physicochem Eng Asp 2022. [DOI: 10.1016/j.colsurfa.2022.129183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Micun Z, Falkowska M, Młynarczyk M, Kochanowicz J, Socha K, Konopińska J. Levels of Trace Elements in the Lens, Aqueous Humour, and Plasma of Cataractous Patients-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10376. [PMID: 36012010 PMCID: PMC9408557 DOI: 10.3390/ijerph191610376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Cataracts are one of the most common causes of effective vision loss. Although most cases of cataracts are related to the ageing process, identifying modifiable risk factors can prevent their onset or progression. Many studies have suggested that micro and macroelement levels, not only in blood serum but also in the lens and aqueous humour, may affect the risk of the occurrence and severity of cataracts. This systematic review aims to summarise existing scientific reports concerning the importance of trace elements in cataractogenesis. Many authors have pointed out elevated or decreased levels of particular elements in distinct ocular compartments. However, it is not known if these alterations directly affect the increased risk of cataract occurrence. Further studies are needed to show whether changes in the levels of these elements are correlated with cataract severity and type. Such information would be useful for determining specific recommendations for micronutrient supplementation in preventing cataractogenesis.
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Affiliation(s)
- Zuzanna Micun
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Martyna Falkowska
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D, 15-222 Bialystok, Poland
| | - Maryla Młynarczyk
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Bialystok, M. Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Katarzyna Socha
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D, 15-222 Bialystok, Poland
| | - Joanna Konopińska
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland
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Muranov KO, Ostrovsky MA. Biochemistry of Eye Lens in the Norm and in Cataractogenesis. BIOCHEMISTRY. BIOKHIMIIA 2022; 87:106-120. [PMID: 35508906 DOI: 10.1134/s0006297922020031] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 06/14/2023]
Abstract
The absence of cellular organelles in fiber cells and very high cytoplasmic protein concentration (up to 900 mg/ml) minimize light scattering in the lens and ensure its transparency. Low oxygen concentration, powerful defense systems (antioxidants, antioxidant enzymes, chaperone-like protein alpha-crystallin, etc.) maintain lens transparency. On the other hand, the ability of crystallins to accumulate age-associated post-translational modifications, which reduce the resistance of lens proteins to oxidative stress, is an important factor contributing to the cataract formation. Here, we suggest a mechanism of cataractogenesis common for the action of different cataractogenic factors, such as age, radiation, ultraviolet light, diabetes, etc. Exposure to these factors leads to the damage and death of lens epithelium, which allows oxygen to penetrate into the lens through the gaps in the epithelial layer and cause oxidative damage to crystallins, resulting in protein denaturation, aggregation, and formation of multilamellar bodies (the main cause of lens opacification). The review discusses various approaches to the inhibition of lens opacification (cataract development), in particular, a combined use of antioxidants and compounds enhancing the chaperone-like properties of alpha-crystallin. We also discuss the paradox of high efficiency of anti-cataract drugs in laboratory settings with the lack of their clinical effect, which might be due to the late use of the drugs at the stage, when the opacification has already formed. A probable solution to this situation will be development of new diagnostic methods that will allow to predict the emergence of cataract long before the manifestation of its clinical signs and to start early preventive treatment.
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Affiliation(s)
- Konstantin O Muranov
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, 119334, Russia.
| | - Mikhail A Ostrovsky
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, 119334, Russia
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Tanito M. Reported evidence of vitamin E protection against cataract and glaucoma. Free Radic Biol Med 2021; 177:100-119. [PMID: 34695546 DOI: 10.1016/j.freeradbiomed.2021.10.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 11/25/2022]
Abstract
Cataract and glaucoma are the major causes of severe visual loss and blindness in older adults. This review article describes the currently available basic and clinical evidence regarding vitamin E protection against these eye diseases in the chronologic order of the publications. Experimental evidence has suggested both that oxidative stress due to the accumulation of free radicals plays a role in the pathogenesis of cataracts and glaucoma and that the process can be prevented or ameliorated by vitamin E. The results of observational studies have been inconsistent regarding the association between blood vitamin E levels and the risk of age-related cataract or glaucoma. Despite the encouraging effects of vitamin E from case series, case-control studies, and cross-sectional studies in humans, the effects on cataract formation and/or progression have not been consistent among prospective and randomized control studies; few randomized control studies have tested the effects of supplemental vitamin E on glaucoma development or progression. Given the high prevalence of cataract and glaucoma in the elderly population, even a modest reduction in the risk for these eye diseases would potentially have a substantial public health impact; however, the potential benefits of vitamin E on cataract or glaucoma remain inconclusive and need to be carefully considered.
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Affiliation(s)
- Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, 89-1 Enya, Izumo, Shimane, 693-8501, Japan.
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Motlagh Moghaddam EA, Motarjemizadeh G, Ayremlou P, Zarrin R. Major dietary patterns in relation to age-related cataract. Clin Nutr ESPEN 2021; 41:325-330. [PMID: 33487285 DOI: 10.1016/j.clnesp.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Dietary pattern (DP) may play an important role in the formation of Age-related cataract (ARC). The objective of the study was to investigate the association between DP and ARC. METHODS Participants (120 cases and 240 controls) aged 50-80 years were selected from the ophthalmology clinic of Urmia Imam Khomeini Educational Hospital in the Northwest of Iran by the simple random sampling method between 2017 and 2018. Participants in matched case-control study were free of diabetes, autoimmune diseases and cancer. Factor analysis method was used to identify the major DPs. The association between participants' DPs and ARC were evaluated using logistic regression analysis in SPSS20. RESULTS Four major DPs were found and nominated: "Unhealthy", "Healthy", "Salty foods" and "Mixed" patterns. In continues model the Unhealthy pattern was positively associated with the risk of ARC disease (odds ratio in adjusted model was 5.71; 95% CI: 3.68-8.87, P trend< 0.001). The Healthy pattern was inversely associated with the ARC (odds ratio in adjusted model was 0.48; 95% CI: 0.34-0.67, Ptrend = 0.02). The Salty foods pattern was associated with ARC (odds ratio in adjusted model was 1.45; 95% CI; 1.04-2.02, Ptrend = 0.03). The association between ARC disease and Mixed patterns was not statistically significant. CONCLUSION The results indicate that Unhealthy and Salty foods patterns were associated with increased risk of ARC. Further prospective studies are needed to confirm such an association.
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Affiliation(s)
| | | | - Parvin Ayremlou
- Clinical Research Development Unit of Imam Khomeini Educational Hospital, Urmia University of Medical Sciences, Urmia, Iran.
| | - Rasoul Zarrin
- Nutrition Department, School of Medicine, The Urmia University of Medical Sciences, NazlouPardis, Sero Road, Urmia, Iran.
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Qin YJ, Chan SO, Lin HL, Zhang YQ, Chen YL, Niu YY, Xie WJ, Chu WK, Pang CP, Zhang HY. Elevated level of uric acid in aqueous humour is associated with posterior subcapsular cataract in human lens. Clin Exp Ophthalmol 2020; 48:1183-1191. [PMID: 32713071 DOI: 10.1111/ceo.13835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/16/2020] [Accepted: 07/11/2020] [Indexed: 02/05/2023]
Abstract
IMPORTANCE Age-related cataract is the leading cause of blindness worldwide. The pathological mechanisms causing this disease remain elusive. BACKGROUND To examine the involvement of uric acid (UA) in the pathogenesis of posterior subcapsular cataract (PSC). DESIGN Retrospective study and experimental investigation. PARTICIPANTS A total of 180 patients with PSC or non-PSC were included. METHODS Samples obtained from the patients were used to analyse content of UA and for histochemical examinations. The effects of UA on human lens epithelial cells were also investigated. MAIN OUTCOME MEASURES Aqueous humour UA and urate deposits. RESULTS The results showed a significant increase of aqueous humour UA in patients with PSC. After adjustment for potential confounders, elevated aqueous humour UA (odds ratio [OR] = 1.45) showed a stronger association with PSC than serum UA (OR = 1.10). Gomori methenamine silver staining revealed in PSC an intense deposit of urates in the lens fibres in equatorial regions, and in subcapsular fibres in posterior regions of the lens. Such staining was not detected in the lens with non-PSC. Treatment with UA-induced senescence and apoptosis in human lens epithelial cells in a dose dependent manner. Our results suggest that the elevated level of UA in aqueous humour causes a deposition of urates in human lens epithelium, which could possibly lead to dysfunction of these cells that generates opacification in PSC. CONCLUSIONS AND RELEVANCE These findings indicate the local action of excessive UA in the pathogenesis of PSC. Control of serum UA level could delay the progression of PSC.
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Affiliation(s)
- Yong Jie Qin
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Sun On Chan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Hong Liang Lin
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Yu Qiao Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Yan Lei Chen
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Yong Yi Niu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Wen Juan Xie
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Wai Kit Chu
- Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Hong Yang Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
- School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Wholegrain and legume consumption and the 5-year incidence of age-related cataract in the Blue Mountains Eye Study. Br J Nutr 2020; 124:306-315. [PMID: 32189601 DOI: 10.1017/s000711452000104x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The present study aims to investigate the effect of wholegrain and legume consumption on the incidence of age-related cataract in an older Australian population-based cohort. The Blue Mountains Eye Study (BMES) is a population-based cohort study of eye diseases among older adults aged 49 years or older (1992-1994, n 3654). Of 2334 participants of the second examination of the BMES (BMES 2, 1997-2000), 1541 (78·3 % of survivors) were examined 5 years later (BMES 3) who had wholegrain and legume consumption estimated from the FFQ at BMES 2. Cataract was assessed using photographs taken during examinations following the Wisconsin cataract grading system. Multivariable-adjusted logistic regression models were used to assess associations with the 5-year incidence of cataract from BMES 2 (baseline) to BMES 3. The 5-year incidence of cortical, nuclear and posterior subcapsular (PSC) cataract was 18·2, 16·5 and 5·9 %, respectively. After adjustment for age, sex and other factors, total wholegrain consumption at baseline was not associated with incidence of any type of cataract. High consumption of legumes showed a protective association for incident PSC cataract (5th quintile: adjusted OR 0·37; 95 % CI 0·15, 0·92). There was no significant trend of this association across quintiles (P = 0·08). In this older Australian population, we found no associations between wholegrain intake at baseline and the 5-year incidence of three cataract types. However, intake of legumes in the highest quintile, compared with the lowest quintile, may protect against PSC formation, a finding needing replication in other studies.
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Sharma A, Khosla A, Arya S. Synthesis of SnO2 nanowires as a reusable and flexible electrode for electrochemical detection of riboflavin. Microchem J 2020. [DOI: 10.1016/j.microc.2020.104858] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Thakur K, Tomar SK, Singh AK, Mandal S, Arora S. Riboflavin and health: A review of recent human research. Crit Rev Food Sci Nutr 2018; 57:3650-3660. [PMID: 27029320 DOI: 10.1080/10408398.2016.1145104] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There has lately been a renewed interest in Riboflavin owing to insight into its recognition as an essential component of cellular biochemistry. The knowledge of the mechanisms and regulation of intestinal absorption of riboflavin and its health implications has significantly been expanded in recent years. The purpose of this review is to provide an overview of the importance of riboflavin, its absorption and metabolism in health and diseased conditions, its deficiency and its association with various health diseases, and metabolic disorders. Efforts have been made to review the available information in literature on the relationship between riboflavin and various clinical abnormalities. The role of riboflavin has also been dealt in the prevention of a wide array of health diseases like migraine, anemia, cancer, hyperglycemia, hypertension, diabetes mellitus, and oxidative stress directly or indirectly. The riboflavin deficiency has profound effect on iron absorption, metabolism of tryptophan, mitochondrial dysfunction, gastrointestinal tract, brain dysfunction, and metabolism of other vitamins as well as is associated with skin disorders. Toxicological and photosensitizing properties of riboflavin make it suitable for biological use, such as virus inactivation, excellent photosensitizer, and promising adjuvant in chemo radiotherapy in cancer treatment. A number of recent studies have indicated and highlighted the cellular processes and biological effects associated with riboflavin supplementation in metabolic diseases. Overall, a deeper understanding of these emerging roles of riboflavin intake is essential to design better therapies for future.
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Affiliation(s)
- Kiran Thakur
- a Dairy Microbiology Division , ICAR-National Dairy Research Institute , Karnal , Haryana , India
| | - Sudhir Kumar Tomar
- a Dairy Microbiology Division , ICAR-National Dairy Research Institute , Karnal , Haryana , India
| | - Ashish Kumar Singh
- b Dairy Technology Division , ICAR-National Dairy Research Institute , Karnal , Haryana , India
| | - Surajit Mandal
- a Dairy Microbiology Division , ICAR-National Dairy Research Institute , Karnal , Haryana , India
| | - Sumit Arora
- c Dairy Chemistry Division , ICAR-National Dairy Research Institute , Karnal , Haryana , India
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Glaser TS, Doss LE, Shih G, Nigam D, Sperduto RD, Ferris FL, Agrón E, Clemons TE, Chew EY. The Association of Dietary Lutein plus Zeaxanthin and B Vitamins with Cataracts in the Age-Related Eye Disease Study: AREDS Report No. 37. Ophthalmology 2015; 122:1471-9. [PMID: 25972257 DOI: 10.1016/j.ophtha.2015.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/27/2015] [Accepted: 04/06/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate whether dietary intake of luteiin/zeaxanthin and B vitamins is associated with cataract prevalence and incidence. DESIGN Clinic-based, baseline cross-sectional and prospective cohort study designs. PARTICIPANTS Three thousand one hundred fifteen patients (6129 eyes) enrolled in the Age-Related Eye Disease Study 55 to 80 years of age followed up for mean of 9.6 years. METHODS Participants completed baseline food frequency questionnaires. Baseline and annual lens photographs were graded centrally. Multivariate models controlling for previously identified risk factors for cataracts tested for the association of cataracts with reported dietary intake, using the lowest quintile as reference. MAIN OUTCOME MEASURES Cataract surgery, cataract status (type and severity) at baseline, and development of cataracts. RESULTS At baseline, increased dietary riboflavin and B12 were associated inversely with nuclear and cortical lens opacities. In comparisons of persons with and without cataract, persons with the highest riboflavin intake versus those with the lowest intake had the following associations: mild nuclear cataract: odds ratio (OR), 0.78; 95% confidence interval (CI), 0.63-0.97; moderate nuclear cataract: OR, 0.62; 95% CI, 0.43-0.90; and mild cortical cataract: OR, 0.80; 95% CI, 0.65-0.99. For B12, the results were: mild nuclear cataract: OR, 0.78; 95% CI, 0.63-0.96; moderate nuclear cataract: OR, 0.62; 95% CI, 0.43-0.88; and mild cortical cataract: OR, 0.77; 95% CI, 0.63-0.95. Highest dietary B6 intake was associated with a decreased risk of moderate nuclear lens opacity developing compared with the lowest quintile (OR, 0.67; 95% CI, 0.45-0.99). Highest dietary intake levels of niacin and B12 were associated with a decreased risk of development of mild nuclear or mild cortical cataracts in participants not taking Centrum (Pfizer, New York, NY) multivitamins. For participants taking multivitamins during the study, the highest intake of dietary folate was associated with an increased risk of mild posterior subcapsular lens opacity development. No statistically significant associations were found between lutein plus zeaxanthin intake and presence at baseline or development of nuclear or cortical lens opacity outcomes. CONCLUSIONS These findings are consistent with earlier studies suggesting that dietary intake of B vitamins may affect the occurrence of age-related lens opacities. Further investigations are warranted.
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Affiliation(s)
- Tanya S Glaser
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Lauren E Doss
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Grace Shih
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Divya Nigam
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Frederick L Ferris
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Elvira Agrón
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Emily Y Chew
- National Eye Institute, National Institutes of Health, Bethesda, Maryland.
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Abstract
AbstractObjectiveWe conducted a meta-analysis to evaluate the relationship between vitamin E and age-related cataract (ARC).DesignThe fixed- or random-effect model was selected based on heterogeneity. Meta-regression was used to explore potential sources of between-study heterogeneity. Publication bias was evaluated using Begg’s test. The dose–response relationship was assessed by a restricted cubic spline model.SettingRelevant studies were identified by a search of PubMed and the Cochrane Library to May 2014, without language restrictions.SubjectsStudies involved samples of people of all ages.ResultsDietary vitamin E intake, dietary and supplemental vitamin E intake, and high serum tocopherol levels were significantly associated with decreased risk of ARC, the pooled relative risk was 0·73 (95 % CI 0·58, 0·92), 0·86 (95 % CI 0·75, 0·99) and 0·77 (95 % CI 0·66, 0·91), respectively. Supplemental vitamin E intake was non-significantly associated with ARC risk (relative risk=0·92; 95 % CI 0·78, 1·07). The findings from dose–response analysis showed evidence of a non-linear association between dietary vitamin E intake and ARC. The risk of ARC decreased with dietary vitamin E intake from 7 mg/d (relative risk=0·94; 95 % CI 0·90, 0·97).ConclusionsThe findings of the meta-analysis indicated that dietary vitamin E intake, dietary and supplemental vitamin E intake, and high level of serum tocopherol might be significantly associated with reduced ARC risk.
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Abstract
There is evidence from epidemiologic data that cataract is more common in women than men. This is not solely due to a higher rate of cataract extraction in women, as is the case in the western world, but several population-based studies show that females have a higher prevalence of lens opacities, especially cortical. There is no firm evidence that lifestyle-related factors are the cause of this gender discrepancy. Focus has therefore been directed towards the role of estrogen in cataract formation. Although data on endogenous and exogenous estrogen involvement in cataractogenesis are conflicting, some studies have indicated that hormone therapy may decrease the risk of cataract and thus be protective. It has been hypothesized that the decrease in estrogen at menopause cause increased risk of cataract in women, i.e. not strictly the concentration of estrogen, but more the withdrawal effect. Estrogens are known to exert several anti-aging effects that may explain the longer lifespan in women, including metabolically beneficial effects, neuroprotection, preservation of telomeres and anti-oxidative properties. Since oxidative stress is considered important in cataractogenesis, studies have investigated the effects of estrogens on lens epithelial cells in culture or in animal models. Several investigators have found protection by physiological concentrations of 17β-estradiol against oxidative stress induced by H2O2 in cultured lens epithelial cells. Although both main types of estrogen receptors, ERα and ERβ, have been demonstrated in lens epithelium, most studies so far indicate that the estrogen-mediated protection in the lens is exerted through non-genomic, i.e. receptor-independent mechanisms, possibly through phosphorylation of extracellular signal-regulated kinase (ERK1/ERK2), a member of the mitogen-activated protein kinase (MAPK)-signaling pathway. Further studies are needed, both epidemiologic as to the role of hormone therapies, and laboratory studies regarding molecular estrogen-mediated mechanisms, in order to comprehend the role of estrogens on cataract formation.
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Affiliation(s)
- Madeleine Zetterberg
- Department of Clinical Neuroscience and Rehabilitation/Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
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Zhao LQ, Li LM, Zhu H, The Epidemiological Evidence-Based Eye Disease Study Research Group EY. The effect of multivitamin/mineral supplements on age-related cataracts: a systematic review and meta-analysis. Nutrients 2014; 6:931-49. [PMID: 24590236 PMCID: PMC3967170 DOI: 10.3390/nu6030931] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 01/15/2014] [Accepted: 01/24/2014] [Indexed: 01/19/2023] Open
Abstract
Antioxidant vitamins supplements have been suggested as a strategy to decrease the risk of age-related cataract development. However, the results from observational studies and interventional trials of associations between antioxidant vitamins A, C, and E and cataract development have been inconsistent. We aim to evaluate the effectiveness of multivitamin/mineral supplements for decreasing the risk of age-related cataracts by conducting a systematic review and meta-analysis. In September 2013, we searched multiple databases to identify relevant studies including both cohort studies and randomized controlled trials (RCTs). A random-effects model was used to calculate the pooled relative risks (RR) with a 95% confidence interval (CI). Twelve prospective cohort studies and two RCTs were included. Pooled results from the cohort studies indicated that multivitamin/mineral supplements have a significant beneficial effect in decreasing the risk of nuclear cataracts (RR: 0.73; 95% CI: 0.64-0.82), cortical cataracts (RR: 0.81; 95% CI: 0.68-0.94), and any cataracts (RR: 0.66; 95% CI: 0.39-0.93). In addition, there were no decreases in the risk of posterior capsular cataracts (RR: 0.96; 95% CI: 0.72-1.20) or cataract surgery (RR: 1.00; 95% CI: 0.92-1.08). The two RCTs demonstrated that multivitamin/mineral supplements could decrease the risk of nuclear cataracts. There is sufficient evidence to support the role of dietary multivitamin/mineral supplements for the decreasing the risk of age-related cataracts.
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Affiliation(s)
- Li-Quan Zhao
- Department of Ophthalmology, No. 181 Hospital of the PLA, No.1 Xinqiaoyuan Road, Guilin 541002, China.
| | - Liang-Mao Li
- Department of Ophthalmology, No. 181 Hospital of the PLA, No.1 Xinqiaoyuan Road, Guilin 541002, China.
| | - Huang Zhu
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Road, Shanghai 200092, China.
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Gupta VB, Rajagopala M, Ravishankar B. Etiopathogenesis of cataract: an appraisal. Indian J Ophthalmol 2014; 62:103-10. [PMID: 24618482 PMCID: PMC4005220 DOI: 10.4103/0301-4738.121141] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 11/06/2012] [Indexed: 11/04/2022] Open
Abstract
Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc.), traumatic, complicated (inflammatory and degenerative diseases of eye), metabolic (diabetes, galactosemia etc.), toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc.) are implicated as significant risk factors in the development of cataract.
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Affiliation(s)
- Varun B Gupta
- Research Associate, Ayurgenomics-TRISUTRA Project, Gujarat Ayurved University, Jamnagar, India
| | - Manjusha Rajagopala
- Department of Panchakarma, IPGT & RA, Gujarat Ayurved University, Jamnagar, India
| | - Basavaiah Ravishankar
- Director, SDM Center for Research in Ayurveda and Allied Sciences, Udupi, Karnataka, India
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The Impact of Senile Cataract Maturity on Blood Oxidative Stress Markers and Glutathione-Dependent Antioxidants: Relations with Lens Variables. J Med Biochem 2012. [DOI: 10.2478/v10011-012-0003-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Impact of Senile Cataract Maturity on Blood Oxidative Stress Markers and Glutathione-Dependent Antioxidants: Relations with Lens VariablesOxidative stress is implicated in senile cataract (SC) genesis, although the impact of SC maturity on blood oxidative stress markers is unclear. Total hydroperoxides, malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione S-transferase (GST) were measured in the blood and lens samples of patients having either immature (n=31) or mature SC (n=50), and in 22 blood samples from noncataract controls. Compared to controls, SC patients had higher plasma MDA and serum GST, and decreased plasma GR and GSH levels. Plasma GPx as well as hydroperoxides differed from control values only in patients with mature SC. The multivariate logistic regression analysis showed that the fall of plasma GR activity (OR 5.14; CI 1.82-14.51;p=0.0020), as well as serum GST activity (OR 3.84; CI 1.36-10.83;p=0.0108) were independently associated with the maturity of SC. Lens hydroperoxides, MDA and GST, showed no correlation with correspondent blood values, in contrast to GPx (r=0.715; p<0.001) and GR (r=0.703; p<0.001). This study showed that the severity of SC is associated with increased systemic oxidative stress, which could be due to the fall of GSH-dependent antioxidant enzymes activities.
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Mathew MC, Ervin AM, Tao J, Davis RM. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane Database Syst Rev 2012; 6:CD004567. [PMID: 22696344 PMCID: PMC4410744 DOI: 10.1002/14651858.cd004567.pub2] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Age-related cataract is a major cause of visual impairment in the elderly. Oxidative stress has been implicated in its formation and progression. Antioxidant vitamin supplementation has been investigated in this context. OBJECTIVES To assess the effectiveness of antioxidant vitamin supplementation in preventing and slowing the progression of age-related cataract. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 2), MEDLINE (January 1950 to March 2012), EMBASE (January 1980 to March 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to March 2012), Open Grey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 2 March 2012. We also checked the reference lists of included studies and ongoing trials and contacted investigators to identify eligible randomized trials. SELECTION CRITERIA We included only randomized controlled trials in which supplementation with one or more antioxidant vitamins (beta-carotene, vitamin C and vitamin E) in any form, dosage or combination for at least one year was compared to another antioxidant vitamin or to placebo. DATA COLLECTION AND ANALYSIS Two authors extracted data and assessed trial quality independently. We pooled results for the primary outcomes, i.e., incidence of cataract and incidence of cataract extraction. We did not pool results of the secondary outcomes - progression of cataract and loss of visual acuity, because of differences in definitions of outcomes and data presentation. We pooled results by type of cataract when data were available. We did not perform a sensitivity analysis. MAIN RESULTS Nine trials involving 117,272 individuals of age 35 years or older are included in this review. The trials were conducted in Australia, Finland, India, Italy, the United Kingdom and the United States, with duration of follow-up ranging from 2.1 to 12 years. The doses of antioxidant vitamins were higher than the recommended daily allowance. There was no evidence of effect of antioxidant vitamin supplementation in reducing the risk of cataract, cataract extraction, progression of cataract or in slowing the loss of visual acuity. In the pooled analyses, there was no evidence of effect of beta-carotene supplementation in reducing the risk of cataract (two trials) (relative risk (RR) 0.99, 95% confidence interval (CI) 0.91 to 1.08; n = 57,703) or in reducing the risk of cataract extraction (three trials) (RR 1.00, 95% CI 0.91 to 1.10; n = 86,836) or of vitamin E supplementation in reducing the risk of cataract (three trials) (RR 0.97, 95% CI 0.91 to 1.04; n = 50,059) or of cataract extraction (five trials) (RR 0.98, 95% CI 0.91 to 1.05; n = 83,956). The proportion of participants developing hypercarotenodermia (yellowing of skin) while on beta-carotene ranged from 7.4% to 15.8%. AUTHORS' CONCLUSIONS There is no evidence from RCTs that supplementation with antioxidant vitamins (beta-carotene, vitamin C or vitamin E) prevents or slows the progression of age-related cataract. We do not recommend any further studies to examine the role of antioxidant vitamins beta-carotene, vitamin C and vitamin E in preventing or slowing the progression of age-related cataract. Costs and adverse effects should be weighed carefully with unproven benefits before recommending their intake above recommended daily allowances.
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Affiliation(s)
- Milan C Mathew
- MetroWest Medical Center, Framingham, Massachusetts, USA.
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Ravindran RD, Vashist P, Gupta SK, Young IS, Maraini G, Camparini M, Jayanthi R, John N, Fitzpatrick KE, Chakravarthy U, Ravilla TD, Fletcher AE. Inverse association of vitamin C with cataract in older people in India. Ophthalmology 2011; 118:1958-1965.e2. [PMID: 21705085 PMCID: PMC3185206 DOI: 10.1016/j.ophtha.2011.03.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 01/25/2011] [Accepted: 03/08/2011] [Indexed: 11/21/2022] Open
Abstract
Objective To examine the association between vitamin C and cataract in the Indian setting. Design Population-based cross-sectional analytic study. Participants A total of 5638 people aged ≥60 years. Methods Enumeration of randomly sampled villages in 2 areas of north and south India to identify people aged ≥60 years. Participants were interviewed for socioeconomic and lifestyle factors (tobacco, alcohol, household cooking fuel, work, and diet); attended a clinical examination, including lens photography; and provided a blood sample for antioxidant analysis. Plasma vitamin C was measured using an enzyme-based assay in plasma stabilized with metaphosphoric acid, and other antioxidants were measured by reverse-phase high-pressure liquid chromatography. Main Outcome Measures Cataract and type of cataract were graded from digital lens images using the Lens Opacity Classification System III (LOCS III), and cataract was classified from the grade in the worse eye of ≥4 for nuclear cataract, ≥3 for cortical cataract, and ≥2 for posterior subcapsular cataract (PSC). Any cataract was defined as any unoperated or operated cataract. Results Of 7518 enumerated people, 5638 (75%) provided data on vitamin C, antioxidants, and potential confounders. Vitamin C was inversely associated with cataract (adjusted odds ratio [OR] for highest to lowest quartile = 0.61; 95% confidence interval (CI), 0.51–0.74; P=1.1×10−6). Inclusion of other antioxidants in the model (lutein, zeaxanthin, retinol, β-carotene, and α-tocopherol) made only a small attenuation to the result (OR 0.68; 95% CI, 0.57–0.82; P < 0.0001). Similar results were seen with vitamin C by type of cataract: nuclear cataract (adjusted OR 0.66; CI, 0.54–0.80; P < 0.0001), cortical cataract (adjusted OR 0.70; CI, 0.54–0.90; P < 0.002), and PSC (adjusted OR 0.58; CI, 0.45–0.74; P < 0.00003). Lutein, zeaxanthin, and retinol were significantly inversely associated with cataract, but the associations were weaker and not consistently observed by type of cataract. Inverse associations were also observed for dietary vitamin C and cataract. Conclusions We found a strong association with vitamin C and cataract in a vitamin C–depleted population. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Abstract
Riboflavin (vitamin B 2) is not synthesized by vertebrates and must be supplied by diet. It is found in most foods, with the highest content in dairy products, meat, and dark green vegetables. Deficiency rarely occurs alone where adequate food is available and usually occurs as a multinutrient deficiency. Some conditions and medications can decrease effectiveness or levels of riboflavin. Supplementation is rarely needed to prevent ariboflavinosis when a normal diet is consumed. Supplementation for decreased frequency of migraine headaches and prevention of age related cataracts could be beneficial. There is no known toxicity.
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Interrelationships between nutritional status, socioeconomic factors, and lifestyle in Indian cataract patients. Nutrition 2010; 27:40-45. [PMID: 20472398 DOI: 10.1016/j.nut.2009.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 08/10/2009] [Accepted: 11/14/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The etiology of cataracts in the Asian subcontinent is not well understood. The aim of this study was to understand the differences in nutritional and lifestyle-related etiology of cataract in a high-income group (HIG) and a low-income group (LIG). RESEARCH METHODS A cross-sectional survey was conducted on 140 cataract patients, aged 50-70 y, and 100 age- and sex-matched healthy controls. Socioeconomic information and habitual dietary intake were recorded by interview method. Cataract grading was given by ophthalmologists using a slit-lamp biomicroscope. RESULTS In HIG patients, there was a delay of 10 y in the onset of cataracts as compared to LIG patients. Sixty-seven percent of LIG patients were alcoholic and 80% had a family history of cataracts. Further, among LIG male patients, 45%-87% were uneducated and 80% were addicted to tobacco. The intake of animal foods and fried foods was significantly higher in all the patient groups than controls (P<0.001). The intake of vegetables, fruits, salads, and tea were higher in all the controls than patients (P<0.001). For HIG male patients, between alcoholics and non-alcoholics, significant differences were noted for antioxidant status and soluble to total proteins ratio of lens. Similar differences were seen between HIG male smokers and non-smokers. Multiple regression analysis of solubility and opacity of lens indicated influence of family size, sunlight exposure, and systolic blood pressure for predisposition of cataracts. CONCLUSIONS Along with high systolic blood pressure, waist:hip ratio, family size, sunlight exposure, and increased consumption of tobacco and alcohol were the risk factors for cataracts.
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Ferrigno L, Aldigeri R, Rosmini F, Sperduto RD, Maraini G. Associations Between Plasma Levels of Vitamins and Cataract in the Italian-American Clinical Trial of Nutritional Supplements and Age-Related Cataract (CTNS): CTNS Report #2. Ophthalmic Epidemiol 2009; 12:71-80. [PMID: 16019690 DOI: 10.1080/09286580590932815] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate the association at baseline between plasma levels of selected vitamins and the presence and type of cataract in the participants in The Italian-American Trial of Nutritional Supplements and Age-related Cataract. METHODS At baseline, the participants (1020, 710 with "early cataract" and 310 with "no cataract," 55-75 years of age) received an ocular examination, photographic lens grading, and measurement of plasma levels of vitamins A, C, E, beta-carotene, and of red blood cell glutathione reductase activity. RESULTS In multiple logistic models adjusted for potential confounders, high vitamin C levels were associated with a protective effect on nuclear (N) [OR: 0.54; 95% CI: 0.30, 0.97] and posterior subcapsular (PSC) cataract (OR: 0.37; 95% CI: 0.15, 0.93). High vitamin E levels were associated with increased prevalence of cortical cataract (C) (OR: 1.99; 95% CI: 1.02-3.90), PSC (OR: 3.27; 95% CI: 1.34, 7.96) and of any cataract (OR: 1.86; 95% CI: 1.08, 3.18). CONCLUSIONS In agreement with some earlier studies, we found higher plasma levels of vitamin C to be associated with reduced prevalence of N and PSC cataracts. The finding of an increased prevalence of some types of cataract with higher levels of vitamin E was unexpected, has not been previously reported, and could be due to unadjusted confounding.
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Affiliation(s)
- L Ferrigno
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, ISS, Rome, Italy
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Gritz DC, Srinivasan M, Smith SD, Kim U, Lietman TM, Wilkins JH, Priyadharshini B, Aravind S, Prajna NV, Smolin G, Thulasiraj RD, Selvaraj S, Whitcher JP. Antioxidants in Prevention of Cataracts in South India: Methodology and Baseline Data. Ophthalmic Epidemiol 2009; 13:97-107. [PMID: 16581613 DOI: 10.1080/09286580500477366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To describe the methodology and baseline data for the Antioxidants in Prevention of Cataracts (APC) study in South India. METHODS The APC study is a prospective, 5-year, randomized, triple-masked, placebo-controlled, field-based clinical trial to examine the effect of antioxidants (combination tablet of vitamins A, C, and E) on progression of cataract. The primary outcome variable is cataract progression (nuclear opalescence), evaluated with the slit-lamp biomicroscope by the Lens Opacification Classification System III method. Secondary outcome variables are progression in cortical and posterior subcapsular opacity and nuclear color, change in best corrected visual acuity, myopic shift, and treatment failure (progression to cataract surgery or best corrected vision worse than 20/400 in an eye). Inclusion criteria are age between 35 and 50 years and best-corrected visual acuity of 20/40 or better. Exclusion criteria are a diagnosis of diabetes mellitus or nonfasting blood glucose level>7.8 mmol/L, history or presence of various ocular conditions or treatment forms, or current use of vitamin supplements. Baseline ophthalmic, demographic, and potential cataract risk factor data (such as smoking, sunlight, or alcohol exposure) were compared between groups on an intent-to-treat basis. RESULTS Of 954 people screened, 798 were enrolled, a sample size which exceeded the required estimate. More than 80% of subjects had 20/20 or better vision in at least one eye, and baseline prevalence of significant cataract according to the LOCS III grading scale was high. The two treatment groups were comparable for all baseline measures except alcohol intake. CONCLUSION The sample size and group baseline characteristics will provide sufficient power to detect a change in cataract progression within 5 years.
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Affiliation(s)
- David C Gritz
- Department of Ophthalmology, Beckman Vision Center, University of California, San Francisco, CA, USA.
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Zoric L, Miric D, Novakovic T, Pavlovic A, Videnovic G, Trajkovic G. Age-Related Cataract and Serum Albumin Concentration. Curr Eye Res 2009; 33:587-90. [DOI: 10.1080/02713680802213622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Horwath-Winter J, Kirchengast S, Meinitzer A, Wachswender C, Faschinger C, Schmut O. Determination of uric acid concentrations in human tear fluid, aqueous humour and serum. Acta Ophthalmol 2009; 87:188-92. [PMID: 18547277 DOI: 10.1111/j.1755-3768.2008.01215.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE The aim of this investigation was to assess and compare levels of uric acid in human tear fluid, aqueous humour and serum in cataract patients in order to obtain information about uric acid-dependent antioxidative status. METHODS Reflex tear fluid, aqueous humour and serum were obtained from 103 cataract patients (52 women, 51 men). Uric acid was determined by a reversed phase chromatographic method with electrochemical detection. The Randox test was used to measure the contribution of uric acid to the total antioxidative status (TAS) of these body fluids. RESULTS Mean concentrations of uric acid were 20 +/- 8 microg/ml in tear fluid, 18 +/- 6 microg/ml in aqueous humour and 58 +/- 15 microg/ml in serum. Significantly less uric acid was found in tear fluid (p < 0.01) and aqueous humour (p < 0.01) in female cataract patients compared with male cataract patients. There was a significant positive correlation between uric acid content in tear fluid, aqueous humour and serum, respectively (p < 0.01). The contribution of uric acid to TAS (Randox test) amounted to 38% in tear fluid, 10% in aqueous humour and 37% in serum. CONCLUSIONS Uric acid was found in comparable amounts in tear fluid and aqueous humour, but these were two- to threefold lower than in serum. Female cataract patients had lower uric acid values in tear fluid and aqueous humour compared with male cataract patients. Uric acid is an important antioxidant, as proven by its contribution to TAS as determined by the Randox test. The precise role of uric acid in the antioxidative reactions in tear fluid and aqueous humour is still under debate.
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Kim H, Joo CK. The prevalence and demographic characteristics of anterior polar cataract in a hospital-based study in Korea. KOREAN JOURNAL OF OPHTHALMOLOGY 2008; 22:77-80. [PMID: 18612223 PMCID: PMC2629940 DOI: 10.3341/kjo.2008.22.2.77] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Anterior Polar Cataract (APC) develops by a mechanism different from that of other age-related cataracts, and outside of Korea, it is an extremely rare condition. We investigated the prevalence and epidemiological characteristics of APC in Koreans. Methods The evaluation on the prevalence of APC in comparison to the other age-related cataracts was performed on the 2,108 cataract patients who were treated at 5 different areas in Korea from August 2003 to December 2003. The demographic characteristics of APC were studied on the, 656 cataract patients who were treated from January 2004 to January 2005 at one hospital. These patients were classified according to the type of lens opacity (nuclear, cortical, posterior subcapsular, mixed and APC). Results The prevalence of patients with APC among all the cataract patients was 6.02% during the 5 months in this hospital-based study. Eighty-seven per cent of patients with APC were male. In contrast, the proportion of female was greater than 50% in the other cataracts. The mean age of APC patients was 52.7 years. Among the APC patients, 38.9% were under 50 years of age, 42.6% in their 50s, 14.8% in their 60s, and 3.7% were in their 70s. However, 80% of patients were over the age of 60 years in nuclear, cortical, and mixed-type cataracts. Conclusions The prevalence of APC among all cataracts was high in comparision with another country. The proportion of APC was high in individuals younger than 60 years of age, and in males.
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Affiliation(s)
- Hyojin Kim
- Department of Visual Optics, Division of Health Science, Baekseok University, Cheonan, Korea
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Williams PT. Prospective epidemiological cohort study of reduced risk for incident cataract with vigorous physical activity and cardiorespiratory fitness during a 7-year follow-up. Invest Ophthalmol Vis Sci 2008; 50:95-100. [PMID: 18408175 DOI: 10.1167/iovs.08-1797] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To test whether greater vigorous physical activity (kilometers per week run) and greater cardiorespiratory fitness (10-km race performance in meters per second) reduce the incidence of clinically diagnosed cataract. METHODS Prospective cohort study of self-reported clinical diagnosis of cataract in nondiabetic, nonvegetarian, and nonsmoking male (n = 29,025) and female runners (n = 11,967). RESULTS Incident cataracts were reported by 733 (2.53%) men and 179 (1.50%) women during (mean +/- SE) 7.74 +/- 0.01 and 7.42 +/- 0.02 years of follow-up, respectively. The risk for incident cataract increased with BMI, such that the risk in men > 27.5 kg/m(2) was 88% larger than in men < 20 kg/m(2). Men's cataract risk declined significantly in relation to running distance (P = 0.01), even when adjusted for BMI. Men who ran > or = 64 km/wk had 35% lower risk for cataract than those reporting < 16 km/wk (28% lower risk when adjusted for BMI). In addition, men with greater cardiorespiratory fitness were at significantly less risk for development of cataract than were the least fit men. This result was not accounted for by adjustment for running distance or BMI. Compared with the least fit men, those who ran faster than 4.75 m/s had 50% lower risk for incident cataract (43% lower when adjusted for km/wk and BMI). CONCLUSIONS These data suggest that the men's cataract risk decreased in association with lower BMI, greater physical activity, and greater cardiorespiratory fitness, the latter being statistically independent of both BMI and physical activity. The study limitations include the absence of confirmation of the clinical diagnosis and the lack of specificity of the type of cataract.
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Affiliation(s)
- Paul T Williams
- Donner Laboratory, Life Sciences Division, Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA.
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Shah SP, Dineen B, Jadoon Z, Bourne R, Khan MA, Johnson GJ, De Stavola B, Gilbert C, Khan MD. Lens opacities in adults in Pakistan: prevalence and risk factors. Ophthalmic Epidemiol 2008; 14:381-9. [PMID: 18161612 DOI: 10.1080/09286580701375179] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the prevalence and risk factors for lens opacity (LO) amongst a nationally representative sample of the adult population of Pakistan. METHODS This national study of blindness and visual impairment (adults > or =30 years) used multistage, stratified, cluster random sampling. Grading of LO was conducted using the Mehra/Minassian classification system. LO, partly or wholly obscuring the red reflex, or previous cataract surgery were indicators of opacity. RESULTS 16,402 (94.7%) adults were included in this analysis (study conducted 2002-2003). A total of 4,096 (standardized prevalence 20.9%, 95%CI: 20.3, 21.5%) adults were found to have LO. The highest prevalence of LO was found in Punjab province (22.2%), the lowest in Balochistan Province (18.0%). Significant positive associations were increasing age (multivariable odds ratio (OR) 3.2: 95%CI: 3.1, 3.4), hypertension (OR 1.2, 95%CI: 1.1, 1.3), history of diabetes (OR 2.6: 95%CI 2.0, 3.2) and smoking (OR 1.3: 95%CI: 1.1, 1.5). Higher body mass index (BMI) (OR 0.8: 95%CI 0.7, 0.9, heavy vs. normal BMI) and attendance to school (OR 0.6: 95%CI: 0.5, 0.8) were associated with lower risk of LO. Individuals in districts classified as hot were at significantly increased risk (OR 1.3: 95%CI: 1.1, 1.5), and those in wet districts (> 600 mm annual rainfall) had lower odds than individuals living in dry districts (OR 0.7: 95%CI: 0.6, 0.8). CONCLUSIONS Almost a fifth of the adult population had LO. Significant positive associations were age, smoking status, hypertension, diabetes, and increased deprivation level. Protective factors included high BMI and educational achievement. The climatic associations offer novel hypothesis for further research into cataractogenesis.
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Affiliation(s)
- Shaheen P Shah
- International Centre for Eye Health, Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London.
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Christen WG, Glynn RJ, Chew EY, Buring JE. Vitamin E and age-related cataract in a randomized trial of women. Ophthalmology 2007; 115:822-829.e1. [PMID: 18067963 DOI: 10.1016/j.ophtha.2007.06.040] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Revised: 06/08/2007] [Accepted: 06/26/2007] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To investigate whether vitamin E supplementation decreases the risk of age-related cataract in women. DESIGN Randomized, double-masked, placebo-controlled trial. PARTICIPANTS Thirty-nine thousand eight hundred seventy-six apparently healthy female health professionals aged 45 years or older. INTERVENTION Participants were assigned randomly to receive either 600 IU natural-source vitamin E on alternate days or placebo and were followed up for presence of cataract for an average of 9.7 years. MAIN OUTCOME MEASURE Age-related cataract defined as an incident, age-related lens opacity, responsible for a reduction in best-corrected visual acuity to 20/30 or worse, based on self-report and confirmed by medical record review. RESULTS There was no significant difference between the vitamin E and placebo groups in the incidence of cataract (1159 vs. 1217 cases; relative risk [RR], 0.96; 95% confidence interval [CI], 0.88-1.04). In subgroup analyses of subtypes, there were no significant effects of vitamin E on the incidence of nuclear (1056 vs. 1127 cases; RR, 0.94; 95% CI, 0.87-1.02), cortical (426 vs. 461 cases; RR, 0.93; 95% CI, 0.81-1.06), or posterior subcapsular cataract (357 vs. 359 cases; RR, 1.00; 95% CI, 0.86-1.16). Results were similar for extraction of cataract and subtypes. There was no modification of the lack of effect of vitamin E on cataract by baseline categories of age, cigarette smoking, multivitamin use, or several other possible risk factors for cataract. CONCLUSIONS These data from a large trial of apparently healthy female health professionals with 9.7 years of treatment and follow-up indicate that 600 IU natural-source vitamin E taken every other day provides no benefit for age-related cataract or subtypes.
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Affiliation(s)
- William G Christen
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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Townend BS, Townend ME, Flood V, Burlutsky G, Rochtchina E, Wang JJ, Mitchell P. Dietary macronutrient intake and five-year incident cataract: the blue mountains eye study. Am J Ophthalmol 2007; 143:932-939. [PMID: 17459316 DOI: 10.1016/j.ajo.2007.03.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 01/15/2007] [Accepted: 03/08/2007] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the relationships between dietary macronutrient intake at baseline and the five-year incidence of the three main types of cataract in older people. DESIGN Population-based cohort study. METHODS SETTINGS An urban community near Sydney, Australia. STUDY POPULATION The Blue Mountains Eye Study (BMES) examined 3,654 predominantly Caucasian participants aged 49+ years during 1992 to 1994, and then 2,335 survivors (71.5%) after five years. Of these 2,335 subjects, 1988 (85%) completed a Willett-derived food frequency questionnaire (FFQ) at baseline. OBSERVATION PROCEDURES A 145-item FFQ was used to assess nutrient intakes and lens photography was used to assess the presence of cataract at both time points. MAIN OUTCOME MEASURES Incidence of cortical, nuclear, and posterior subcapsular (PSC) cataract was assessed via lens photographic grading following the Wisconsin cataract grading method. RESULTS After adjusting for multiple known cataract risk factors, higher dietary intakes of omega-3 polyunsaturated fatty acids (n-3 PUFA) were associated with a reduced incidence of nuclear cataract. The odds ratio (OR) for subjects in the highest quintile of intake compared to those in the lowest quintile was 0.58 (95% confidence interval [CI] 0.35 to 0.97), P(trend) = .027. Similarly, for PSC cataract, higher dietary intakes of protein were protective (OR 0.28; 95% CI 0.10 to 0.76), P(trend) = .015. Dietary macronutrient intake was not associated with incident cortical cataract. CONCLUSIONS Higher dietary intakes of n-3 PUFA may decrease the five-year risk of nuclear cataract, whereas higher dietary intakes of protein may decrease risk for PSC cataract.
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Affiliation(s)
- Bradley S Townend
- Centre for Vision Research, Department of Ophthalmology and the Westmead Millennium Institute, Westmead, Australia
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Abstract
The prevalence of obesity has reached epidemic proportions in many countries. Although its impact on overall health is well documented, less is known about the ocular manifestations of obesity. Among different eye diseases, obesity has been linked with age-related cataract, glaucoma, age-related maculopathy, and diabetic retinopathy. Numerous population-based and prospective studies support an association between obesity and risk of age-related cataract. However, the nature and strength of these associations, particularly with the different cataract subtypes, remains to be determined. There is strong evidence that obesity is associated with elevated intraocular pressure, but there is no convincing data to support a more direct association between obesity and glaucomatous optic neuropathy. Studies to date have not found a consistent pattern of association between obesity and risk of age-related maculopathy or diabetic retinopathy. Thus, although obesity may be a risk factor for many ocular conditions, the present literature is inadequate to establish any convincing associations. Furthermore, whether weight loss reduces the risk of eye diseases remains unresolved. Because of the potential public health impact of obesity, there is a greater need to understand its ocular effects.
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Affiliation(s)
- Ning Cheung
- Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- Royal Melbourne Hospital, Victoria, Australia
| | - Tien Y. Wong
- Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- Singapore Eye Research Institute, National University of Singapore, Singapore
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Chiu CJ, Taylor A. Nutritional antioxidants and age-related cataract and maculopathy. Exp Eye Res 2006; 84:229-45. [PMID: 16879819 DOI: 10.1016/j.exer.2006.05.015] [Citation(s) in RCA: 134] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Revised: 03/20/2006] [Accepted: 05/14/2006] [Indexed: 12/28/2022]
Abstract
Loss of vision is the second greatest, next to death, fear among the elderly. Age-related cataract (ARC) and maculopathy (ARM) are two major causes of blindness worldwide. There are several important reasons to study relationships between risk for ARC/ARM and nutrition: (1) because it is likely that the same nutritional practices that are associated with prolonged eye function will also be associated with delayed age-related compromises to other organs, and perhaps, aging in general, (2) surgical resources are insufficient to provide economic and safe surgeries for cataract and do not provide a cure for ARM, and (3) there will be considerable financial savings and improvements in quality of life if health rather than old age is extended, particularly given the rapidly growing elderly segment of our population. It is clear that oxidative stress is associated with compromises to the lens and retina. Recent literature indicates that antioxidants may ameliorate the risk for ARC and ARM. Given the association between oxidative damage and age-related eye debilities, it is not surprising that over 70 studies have attempted to relate antioxidant intake to risk for ARC and ARM. This article will review epidemiological literature about ARC and ARM with emphasis on roles for vitamins C and E and carotenoids. Since glycation and glycoxidation are major molecular insults which involve an oxidative stress component, we also review new literature that relates dietary carbohydrate intake to risk for ARC and ARM. To evaluate dietary effects as a whole, several studies have tried to relate dietary patterns to risk for ARC. We will also give some attention to this emerging research. While data from the observational studies generally support a protective role for antioxidants in foods or supplements, results from intervention trials are less encouraging with respect to limiting risk for ARC/ARM prevalence or progress through antioxidant supplementations, or maintaining higher levels of antioxidants either in diet or blood. Without more information it is difficult to parse these results. It would be worthwhile to determine why the various types of studies are not yielding similar results. However, there are many common insults and mechanistic compromises that are associated with aging, and proper nutrition early in life may address some of these compromises and provide for extended youthful function later in life. Indeed, proper nutrition, possibly including use of antioxidant supplements for the nutritionally impoverished, along with healthy life styles may provide the least costly and most practical means to delay ARC and ARM. Further studies should be devoted to identifying the most effective strategy to prevent or delay the development and progress of ARC/ARM. The efforts should include identifying the right nutrient(s), defining useful levels of the nutrient(s), and determining the age when the supplementation should begin.
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Affiliation(s)
- Chung-Jung Chiu
- The Laboratory for Nutrition and Vision Research, USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
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Gritz DC, Srinivasan M, Smith SD, Kim U, Lietman TM, Wilkins JH, Priyadharshini B, John RK, Aravind S, Prajna NV, Duraisami Thulasiraj R, Whitcher JP. The Antioxidants in Prevention of Cataracts Study: effects of antioxidant supplements on cataract progression in South India. Br J Ophthalmol 2006; 90:847-51. [PMID: 16556618 PMCID: PMC1857154 DOI: 10.1136/bjo.2005.088104] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2006] [Indexed: 11/04/2022]
Abstract
AIM To determine if antioxidant supplements (beta carotene and vitamins C and E) can decrease the progression of cataract in rural South India. METHODS The Antioxidants in Prevention of Cataracts (APC) Study was a 5 year, randomised, triple masked, placebo controlled, field based clinical trial to assess the ability of interventional antioxidant supplements to slow cataract progression. The primary outcome variable was change in nuclear opalescence over time. Secondary outcome variables were cortical and posterior subcapsular opacities and nuclear colour changes; best corrected visual acuity change; myopic shift; and failure of treatment. Annual examinations were performed for each subject by three examiners, in a masked fashion. Multivariate modelling using a general estimating equation was used for analysis of results, correcting for multiple measurements over time. RESULTS Initial enrolment was 798 subjects. Treatment groups were comparable at baseline. There was high compliance with follow up and study medications. There was progression in cataracts. There was no significant difference between placebo and active treatment groups for either the primary or secondary outcome variables. CONCLUSION Antioxidant supplementation with beta carotene, vitamins C and E did not affect cataract progression in a population with a high prevalence of cataract whose diet is generally deficient in antioxidants.
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Affiliation(s)
- D C Gritz
- Francis I Proctor Foundation for Research in Opthalmology and the Department of Opthalmology, University of California San Francisco, San Francisco, CA, USA.
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Tan AG, Wang JJ, Rochtchina E, Mitchell P. Comparison of age-specific cataract prevalence in two population-based surveys 6 years apart. BMC Ophthalmol 2006; 6:17. [PMID: 16623958 PMCID: PMC1524813 DOI: 10.1186/1471-2415-6-17] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Accepted: 04/20/2006] [Indexed: 11/17/2022] Open
Abstract
Background In this study, we aimed to compare age-specific cortical, nuclear and posterior subcapsular (PSC) cataract prevalence in two surveys 6 years apart. Methods The Blue Mountains Eye Study examined 3654 participants (82.4% of those eligible) in cross-section I (1992–4) and 3509 participants (75.1% of survivors and 85.2% of newly eligible) in cross-section II (1997–2000, 66.5% overlap with cross-section I). Cataract was assessed from lens photographs following the Wisconsin Cataract Grading System. Cortical cataract was defined if cortical opacity comprised ≥ 5% of lens area. Nuclear cataract was defined if nuclear opacity ≥ Wisconsin standard 4. PSC was defined if any present. Any cataract was defined to include persons who had previous cataract surgery. Weighted kappa for inter-grader reliability was 0.82, 0.55 and 0.82 for cortical, nuclear and PSC cataract, respectively. We assessed age-specific prevalence using an interval of 5 years, so that participants within each age group were independent between the two surveys. Results Age and gender distributions were similar between the two populations. The age-specific prevalence of cortical (23.8% in 1st, 23.7% in 2nd) and PSC cataract (6.3%, 6.0%) was similar. The prevalence of nuclear cataract increased slightly from 18.7% to 23.9%. After age standardization, the similar prevalence of cortical (23.8%, 23.5%) and PSC cataract (6.3%, 5.9%), and the increased prevalence of nuclear cataract (18.7%, 24.2%) remained. Conclusion In two surveys of two population-based samples with similar age and gender distributions, we found a relatively stable cortical and PSC cataract prevalence over a 6-year period. The increased prevalence of nuclear cataract deserves further study.
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Affiliation(s)
- Ava Grace Tan
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Jie Jin Wang
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Elena Rochtchina
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
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Durant JS, Frost NA, Trivella M, Sparrow JM. Risk factors for cataract subtypes waterclefts and retrodots: two case–control studies. Eye (Lond) 2005; 20:1254-67. [PMID: 16227982 DOI: 10.1038/sj.eye.6702087] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
UNLABELLED Waterclefts and retrodots are independently associated with visual impairment, yet a review identified no data on risk factors. PURPOSE To investigate risk factors for these two human lens cataract subtypes. METHOD Two nested case-control studies: The host study comprised 1078 subjects (55 years) attending the Somerset and Avon Eye Study (SAES). In total, 197 watercleft cases (Oxford grade 0.2 in either eye) and 199 retrodot cases (Oxford grade 1.0 in either eye) were individually age/gender matched to controls. Detailed ophthalmic and potential risk factor data were collected, including body mass index (BMI), smoking, alcohol, diabetes, hypertension, analgesics, vitamin supplementation, nutrition, sunlight exposure, dehydration, hormonal (women), blood lipids, glucose, urea, creatinine, uric acid, and vitamin levels. RESULTS For waterclefts, univariable analysis identified BMI, alcohol intake, vitamin status, sunlight, urea, creatinine, and uric acid as possible risk factors. Multivariable analysis identified two independent associations. Total number of 'any' analgesics in the previous year: adjusted P<0.01 (U-shaped risk profile, unadjusted high vs medium use (=reference) OR 2.39, 95% CI 1.35-4.26 with medium use vs none (=reference) OR 0.43, 95% CI 0.26-0.72); total sunlight: adjusted P=0.03 (unadjusted highest exposure vs lowest (=reference) OR 3.25, 95% CI 1.11-9.50). For retrodots, univariable analysis identified alcohol, HRT, and lipids. Multivariable analysis identified two independent associations. Mean number of alcohol units consumed per month, adjusted P=0.02 and HDL cholesterol levels, adjusted P=0.02 (unadjusted ORs NS both). CONCLUSION This is the first available published information on risk factors for the human cataractous lens features waterclefts and retrodots.
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Abstract
The role of nutritional supplementation in prevention of onset or progression of ocular disease is of interest to health care professionals and patients. The aim of this review is to identify those antioxidants most appropriate for inclusion in an ideal ocular nutritional supplement, suitable for those with a family history of glaucoma, cataract, or age-related macular disease, or lifestyle factors predisposing onset of these conditions, such as smoking, poor nutritional status, or high levels of sunlight exposure. It would also be suitable for those with early stages of age-related ocular disease. Literature searches were carried out on Web of Science and PubMed for articles relating to the use of nutrients in ocular disease. Those highlighted for possible inclusion were vitamins A, B, C and E, carotenoids beta-carotene, lutein, and zeaxanthin, minerals selenium and zinc, and the herb, Ginkgo biloba. Conflicting evidence is presented for vitamins A and E in prevention of ocular disease; these vitamins have roles in the production of rhodopsin and prevention of lipid peroxidation respectively. B vitamins have been linked with a reduced risk of cataract and studies have provided evidence supporting a protective role of vitamin C in cataract prevention. Beta-carotene is active in the prevention of free radical formation, but has been linked with an increased risk of lung cancer in smokers. Improvements in visual function in patients with age-related macular disease have been noted with lutein and zeaxanthin supplementation. Selenium has been linked with a reduced risk of cataract and activates the antioxidant enzyme glutathione peroxidase, protecting cell membranes from oxidative damage while zinc, although an essential component of antioxidant enzymes, has been highlighted for risk of adverse effects. As well as reducing platelet aggregation and increasing vasodilation, Gingko biloba has been linked with improvements in pre-existing field damage in some patients with normal tension glaucoma. We advocate that vitamins C and E, and lutein/zeaxanthin should be included in our theoretically ideal ocular nutritional supplement.
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Affiliation(s)
- Hannah Bartlett
- Neurosciences Research Institute, School of Life and Health Sciences, Aston University, Birmingham B4 7ET, UK.
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Varma R, Torres M. Prevalence of lens opacities in Latinos. Ophthalmology 2004; 111:1449-56. [PMID: 15288970 DOI: 10.1016/j.ophtha.2004.01.024] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2003] [Accepted: 01/28/2004] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To estimate the age- and gender-specific prevalence of posterior subcapsular (PSC), nuclear, cortical, and mixed lens opacities in a population-based sample of Latinos 40 years and older. DESIGN Population-based, cross-sectional study. PARTICIPANTS Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS A population-based sample of Latinos underwent a complete eye examination, including assessment of presence and severity of lens opacification, using the slit lamp-based Lens Opacities Classification System II (LOCS II). All lens changes (including pseudophakia/aphakia); any nuclear, PSC, and cortical opacities; and nuclear-only, PSC-only, and cortical-only opacities were evaluated. Frequency distributions and chi-square test analyses were used to determine the age- and gender-specific prevalences for each opacity type. MAIN OUTCOME MEASURES Prevalences of cortical, nuclear, and posterior subcapsular opacities. RESULTS Of the 7789 eligible subjects, 6357 completed a clinical examination (82% participation rate). Of all participants with LOCS II grading, 20% had all lens changes, 7.6% had cortical-only opacities, 3.5% had nuclear-only opacities, 0.4% had PSC-only opacities, and 5.9% had mixed-type opacities. The prevalence of all types of lens opacities increased with age (P<0.0001). Of all participants with mixed opacities, 49% had monocular visual impairment and 20% had binocular impairment. Of all 6357 participants, 3.9% had undergone cataract extraction in at least one eye. CONCLUSION Our data provide the first population-based estimates of the prevalence and severity of lens opacities in Latinos. Cortical opacities were the most common type. The high rate of visual impairment from lens opacities suggests that programs that increase access to cataract surgery for older Latinos could help to reduce the burden of visual impairment in the United States.
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Affiliation(s)
- Rohit Varma
- Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, 90033, USA.
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Kyselova Z, Stefek M, Bauer V. Pharmacological prevention of diabetic cataract. J Diabetes Complications 2004; 18:129-40. [PMID: 15120709 DOI: 10.1016/s1056-8727(03)00009-6] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2002] [Revised: 01/14/2003] [Accepted: 01/22/2003] [Indexed: 11/23/2022]
Abstract
Cataract--opacification of the lens--is closely related to diabetes as one of its major late complications. This review deals with three molecular mechanisms that may be involved in the development of diabetic cataract: nonenzymatic glycation of eye lens proteins, oxidative stress, and activated polyol pathway in glucose disposition. Implications resulting from these mechanisms for possible pharmacological interventions to prevent diabetic cataract are discussed. The article reviews research on potential anticataract agents, including glycation inhibitors, antioxidants, and aldose reductase inhibitors. Information on possible benefits of putative anticataract agents comes from a variety of approaches, ranging from laboratory experiments, both in vitro and in vivo, to epidemiological studies in patients.
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Affiliation(s)
- Z Kyselova
- Institute of Experimental Pharmacology, Slovak Academy of Sciences, Dúbravská cesta 9, 841 04 Bratislava, Slovakia.
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Delcourt C, Carrière I, Delage M, Descomps B, Cristol JP, Papoz L. Associations of cataract with antioxidant enzymes and other risk factors. Ophthalmology 2003; 110:2318-26. [PMID: 14644713 DOI: 10.1016/s0161-6420(03)00713-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To determine the association of potential risk factors, including antioxidant enzymes, with the incidence of cataract. DESIGN Cohort study. PARTICIPANTS At baseline, the Age-Related Eye Diseases (Pathologies Oculaires Liées à l'Age, POLA) Study included 2584 residents of Sète (southern France) aged 60 years or older. From September 1998 to May 2000, a 3-year follow-up examination was performed on 1947 of the 2436 surviving participants (79.9%). METHODS Cataract classification was based on a standardized lens examination at the slit lamp, according to Lens Opacities Classification System III. Biologic measurements were performed at baseline from fasting blood samples. MAIN OUTCOME MEASURES At baseline and follow-up, the presence of cataract was defined as: NC or nuclear opalescence (NO) > or = 4 for nuclear cataract, C > or = 4 for cortical cataract, and P > or = 2 for posterior cataract (PSC) opacities, using opacity grades corrected for interobserver variability. Incidence rates were assessed separately for right and left eyes and for each type of cataract. RESULTS In the multivariate model, the incidence of cortical cataract was increased in subjects with high red blood cell superoxide dismutase activity (odds ratio [OR] 4.2 [1.5-12.1], P = 0.007). The incidence of PSC cataract was increased in subjects with a high level of plasma glutathione peroxidase (OR 1.8 [1.0-3.3], P = 0.05). In addition to age, gender, and opacities at baseline, significant risk factors for incident cataract were: long-duration diabetes (OR 5.8, P = 0.001 for cortical cataract) and lifetime heavy smoking (OR 2.9, P = 0.006 for PSC cataract). CONCLUSIONS Consistent with the baseline analysis, the results of this prospective study suggest that antioxidant enzymes might be implicated in the etiology of cataract.
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Jain AK, Lim G, Langford M, Jain SK. Effect of high-glucose levels on protein oxidation in cultured lens cells, and in crystalline and albumin solution and its inhibition by vitamin B6 and N-acetylcysteine: its possible relevance to cataract formation in diabetes. Free Radic Biol Med 2002; 33:1615-21. [PMID: 12488130 DOI: 10.1016/s0891-5849(02)01109-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Diabetic patients have elevated levels of glucose in their blood and other body fluids. This project studied the effect of high-glucose concentrations (HG) on the protein oxidation in cultured lens cells and in crystalline protein solution. In addition, we also examined the effect of HG on the oxidation and turbidity (aggregation) of albumin protein solution. This study also examined whether vitamin B6 [pyridoxine (P), pyridoxamine (PM)] or n-acetylcysteine (NAC) is capable of preventing protein oxidation similar to that seen in cataracts. For cell culture studies, rabbit lens cells were cultured in control or HG medium at 37 degrees C for 2 d. For studies with protein solution, a buffered solution of serum albumin or crystalline protein was incubated with normal glucose (5 mM) or HG (50-100 mM) in a water bath at 37 degrees C for 4 d. All treatments were carried out with and without the addition of P, PM, or NAC. We found significantly higher levels of carbonyl protein (an index of protein oxidation) in HG-treated compared with normal glucose-treated lens cells and in crystalline protein solution. P, PM, and NAC significantly decreased the protein oxidation in lens cells and crystalline protein solution. We also found significantly higher levels of protein oxidation and turbidity (an index of protein aggregation) and its inhibition by P, PM, and NAC in HG-treated compared with normal glucose-treated albumin solution. This suggests that HG can cause the oxidation and modification of proteins in the lens, and that vitamin B6 and NAC supplementation may be helpful in slowing the oxidation of lens proteins. This study explains the cause of early cataract development and the potential benefit of supplementation with vitamin B6 and NAC in the prevention of the development of cataract among the diabetic population.
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Affiliation(s)
- Aman K Jain
- Caddo Magnet High School, Shreveport, LA 71130, USA.
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Taylor A, Jacques PF, Chylack LT, Hankinson SE, Khu PM, Rogers G, Friend J, Tung W, Wolfe JK, Padhye N, Willett WC. Long-term intake of vitamins and carotenoids and odds of early age-related cortical and posterior subcapsular lens opacities. Am J Clin Nutr 2002; 75:540-9. [PMID: 11864861 DOI: 10.1093/ajcn/75.3.540] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Proper nutrition appears to protect against cataracts. Few studies have related nutrition to the odds of developing cortical or posterior subcapsular (PSC) cataracts. OBJECTIVE We assessed the relation between usual nutrient intakes and age-related cortical and PSC lens opacities. DESIGN We studied 492 nondiabetic women aged 53-73 y from the Nurses' Health Study cohort who were without previously diagnosed cataracts. Usual nutrient intake was calculated as the average intake from 5 food-frequency questionnaires collected over a 13-15-y period before the eye examination. Duration of vitamin supplement use was determined from 7 questionnaires collected during this same period. We defined cortical opacities as grade > or = 0.5 and subcapsular opacities as grade > or =0.3 of the Lens Opacities Classification System III. RESULTS Some lenses had more than one opacity. No nutrient measure was related to prevalence of opacities in the full sample, but significant interactions were seen between age and vitamin C intake (P = 0.02) for odds of cortical opacities and between smoking status and folate (P = 0.02), alpha-carotene (P = 0.02), beta-carotene (P = 0.005), and total carotenoids (P = 0.02) for odds of PSC opacities. For women aged <60 y, a vitamin C intake > or = 362 mg/d was associated with a 57% lower odds ratio (0.43; 95% CI: 0.2, 0.93) of developing a cortical cataract than was an intake <140 mg/d, and use of vitamin C supplements for > or = 10 y was associated with a 60% lower odds ratio (0.40; 0.18, 0.87) than was no vitamin C supplement use. Prevalence of PSC opacities was related to total carotenoid intake in women who never smoked (P = 0.02). CONCLUSIONS Our results support a role for vitamin C in diminishing the risk of cortical cataracts in women aged <60 y and for carotenoids in diminishing the risk of PSC cataracts in women who have never smoked.
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Affiliation(s)
- Allen Taylor
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.
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Abstract
It is clear that oxidative stress is associated with compromises to the lens. Recent literature indicates that antioxidants may ameliorate that risk and may actually decrease risk for cataract. This article will briefly review the etiology of cataract. It will also review the epidemiologic information with emphasis on roles for vitamins C and E and carotenoids. More thorough recent reviews are available.
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Affiliation(s)
- A Taylor
- Laboratory for Nutrition and Vision Research, Department of Nutrition, Biochemistry, and Ophthalmology, Tufts University, 711 Washington Street, Boston, MA 02111, USA.
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Kuzniarz M, Mitchell P, Cumming RG, Flood VM. Use of vitamin supplements and cataract: the Blue Mountains Eye Study. Am J Ophthalmol 2001; 132:19-26. [PMID: 11438049 DOI: 10.1016/s0002-9394(01)00922-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To investigate relationships between use of vitamin supplements and the three principal cataract types in a population-based sample. METHODS We studied 2873 of the 3654 participants (79%) aged 49 to 97 years attending the cross-sectional Blue Mountains Eye Study who completed a detailed food frequency questionnaire, which included type, dose, and duration of vitamin supplement use. Masked grading of nuclear, cortical, and posterior subcapsular opacities from lens photographs was performed, using the Wisconsin method. RESULTS Use of multivitamin supplements was associated with reduced prevalence of nuclear cataract, odds ratio 0.6, 95% confidence interval 0.4 to 1.0, P =.05. For both nuclear and cortical cataract, longer duration of multivitamin use was associated with reduced cataract prevalence (nuclear cataract, trend P =.02; cortical cataract, trend P =.03). Use of thiamin supplements was associated with reduced prevalence of nuclear (odds ratio 0.6, confidence interval 0.4 to 1.0, P =.03, dose trend P =.03) and cortical cataract (odds ratio 0.7, confidence interval 0.5 to 0.9, P =.01, dose trend P =.02). Riboflavin (odds ratio 0.8, confidence interval 0.6 to 1.0, P =.05) and niacin (odds ratio 0.7, confidence interval 0.6 to 1.0, P =.04) supplements exerted a weaker protective influence on cortical cataract. Vitamin A supplements were protective against nuclear cataract (odds ratio 0.4, confidence interval 0.2 to 0.8, P =.01, dose trend P =.01). Folate (odds ratio 0.4, confidence interval 0.2 to 0.9, P =.03) appeared protective for nuclear cataract, whereas both folate (odds ratio 0.6, confidence interval 0.3 to 0.9, P =.01, dose trend P =.04) and vitamin B12 supplements (odds ratio 0.7, confidence interval 0.5 to 1.0, P =.03, dose trend P =.02) were strongly protective against cortical cataract. CONCLUSIONS Long-term use of multivitamins, B group and vitamin A supplements was associated with reduced prevalence of either nuclear or cortical cataract. A strong protective influence on cortical cataract, from use of folate or vitamin B12 supplements, is a new finding.
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Affiliation(s)
- M Kuzniarz
- Departments of Ophthalmology and Public Health & Community Medicine, the University of Sydney, Sydney, Australia
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Affiliation(s)
- A Taylor
- Jean Mayer U.S.D.A. Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA
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Affiliation(s)
- S Y Wu
- Department of Preventive Medicine, University of New York at Stony Brook 11794, USA
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Venkatesh P, Satpal G, Verma L, Kumar TH, Garg S. Antioxidants: Basis concepts in relation to the eye. Indian J Clin Biochem 2001; 16:9-14. [PMID: 23105286 PMCID: PMC3453614 DOI: 10.1007/bf02867562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Antioxidants are a small group of substances that protect living cells from the destructive consequences of powerful oxidizing intermediates that can be formed from oxygen. Situations in which pro-oxidant mechanisms within the body are more active than the antioxidant mechanisms (oxidative stress) predispose and contribute to the pathogenesis of several ailments in various organs of the body. In the eye, pro-oxidant factors have been blamed for the causation of diseases such as age related macular degeneration and senile cataract. The role of pro-oxidants in the genesis of certain diseases is well established however, the effectivity of antioxidants provided to the body by dietary supplementation is inconclusive. In this article we provide a review on the basic concepts of antioxidant-pro-oxidant interaction in relation to its effects on the eye.
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Affiliation(s)
- P Venkatesh
- Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, 29 New Delhi
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Schaumberg DA, Glynn RJ, Christen WG, Hankinson SE, Hennekens CH. Relations of body fat distribution and height with cataract in men. Am J Clin Nutr 2000; 72:1495-502. [PMID: 11101477 DOI: 10.1093/ajcn/72.6.1495] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cataract is the leading cause of blindness worldwide. Body mass index (BMI; in kg/m(2)) is a risk factor for cataract, but other anthropometric measurements may also be important. OBJECTIVE We tested relations of alternative measures of body size, including height and waist-to-hip ratio (WHR), as well as BMI, with cataract. DESIGN This was a prospective follow-up study. We analyzed data from 20271 participants in the Physicians' Health Study who did not have cataract at baseline and for whom there was complete information on weight, height, and other risk factors. For analyses concerning WHR, we excluded 3121 additional men for whom we did not have these measurements, assessed at the ninth year of follow-up. The main outcome measures were incident cataract and cataract surgery. RESULTS Among the 17150 men for whom there were complete data, we confirmed an incident cataract in 1727 during an average of 14 y of follow-up. In proportional hazards regression models that adjusted for many known or suspected risk factors, higher BMI [rate ratio (RR) = 1.25 for >/=27.8 compared with <22, P: for trend = 0. 03], height (RR = 1.23 for >/=184 cm compared with </=170 cm, P: for trend = 0.02), and WHR (RR = 1.31 for top compared with bottom quintile, P: for trend = 0.003) were each independently associated with incident cataract. CONCLUSIONS In addition to BMI, both height and abdominal adiposity are independent risk factors for cataract. These relations are biologically plausible and, if causal, suggest that prevention of obesity and beneficial lifestyle changes resulting in weight loss and reduction of central obesity would lessen the incidence and costs of cataract.
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Affiliation(s)
- D A Schaumberg
- Division of Preventive Medicine and the Channing Laboratory of the Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA.
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Beatty S, Koh H, Phil M, Henson D, Boulton M. The role of oxidative stress in the pathogenesis of age-related macular degeneration. Surv Ophthalmol 2000; 45:115-34. [PMID: 11033038 DOI: 10.1016/s0039-6257(00)00140-5] [Citation(s) in RCA: 1293] [Impact Index Per Article: 53.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Age-related macular degeneration (AMD) is the leading cause of blind registration in the developed world, and yet its pathogenesis remains poorly understood. Oxidative stress, which refers to cellular damage caused by reactive oxygen intermediates (ROI), has been implicated in many disease processes, especially age-related disorders. ROIs include free radicals, hydrogen peroxide, and singlet oxygen, and they are often the byproducts of oxygen metabolism. The retina is particularly susceptible to oxidative stress because of its high consumption of oxygen, its high proportion of polyunsaturated fatty acids, and its exposure to visible light. In vitro studies have consistently shown that photochemical retinal injury is attributable to oxidative stress and that the antioxidant vitamins A, C, and E protect against this type of injury. Furthermore, there is strong evidence suggesting that lipofuscin is derived, at least in part, from oxidatively damaged photoreceptor outer segments and that it is itself a photoreactive substance. However, the relationships between dietary and serum levels of the antioxidant vitamins and age-related macular disease are less clear, although a protective effect of high plasma concentrations of alpha-tocopherol has been convincingly demonstrated. Macular pigment is also believed to limit retinal oxidative damage by absorbing incoming blue light and/or quenching ROIs. Many putative risk-factors for AMD have been linked to a lack of macular pigment, including female gender, lens density, tobacco use, light iris color, and reduced visual sensitivity. Moreover, the Eye Disease Case-Control Study found that high plasma levels of lutein and zeaxanthin were associated with reduced risk of neovascular AMD. The concept that AMD can be attributed to cumulative oxidative stress is enticing, but remains unproven. With a view to reducing oxidative damage, the effect of nutritional antioxidant supplements on the onset and natural course of age-related macular disease is currently being evaluated.
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Affiliation(s)
- S Beatty
- Academic Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester, United Kingdom
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Abstract
PURPOSE To investigate relationships between a wide range of macro- and micronutrients, including antioxidant vitamins, and the three main types of cataract in older people. DESIGN Population-based cross-sectional study. PARTICIPANTS Two thousand nine hundred people aged 49 to 97 years living in an urban community near Sydney, Australia. TESTING Food frequency questionnaires and lens photography. MAIN OUTCOME MEASURE Lens photographs were graded for presence and severity of cortical, nuclear, and posterior subcapsular cataracts. RESULTS Higher intakes of protein, vitamin A, niacin, thiamin, and riboflavin were associated with reduced prevalence of nuclear cataract. After adjusting for multiple known cataract risk factors, the odds ratios for those in the highest intake quintile groups compared to those in the lowest intake quintiles were 0.5 (95% confidence interval [CI], 0.3-0.8) for protein, 0.5 (95% CI, 0.3-0.9) for vitamin A, 0.6 (95% CI, 0.4-0.9) for niacin, 0.6 (95% CI, 0.4-0.9) for thiamin, and 0.5 (95% CI, 0.3-0.9) for riboflavin. Intake of polyunsaturated fats was associated with reduced prevalence of cortical cataract. No nutrients were associated with posterior subcapsular cataract. CONCLUSIONS The nucleus of the lens is particularly sensitive to nutrient deficiencies. Protein, vitamin A, niacin, thiamin, and riboflavin protected against nuclear cataract in this study.
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Affiliation(s)
- R G Cumming
- Department of Public Health and Community Medicine, University of Sydney, Australia.
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