The Lens Opacities Case-Control Study. Risk factors for cataract.
The Lens Opacities Case-Control Study evaluated risk factors for age-related nuclear, cortical, posterior subcapsular, and mixed cataracts. The 1380 participants were ophthalmology outpatients, aged 40 to 79 years, classified into the following groups: posterior subcapsular only, 72 patients; nuclear only, 137 patients; cortical only, 290 patients; mixed cataract, 446 patients; and controls, 435 patients. In polychotomous logistic regression analyses, low education increased risk (odds ratio [OR] = 1.46) and regular use of multivitamin supplements decreased risk (OR = 0.63) for all cataract types. Dietary intake of riboflavin, vitamins C, E, and carotene, which have antioxidant potential, was protective for cortical, nuclear, and mixed cataract; intake of niacin, thiamine, and iron also decreased risk. Similar results were found in analyses that combined the antioxidant vitamins (OR = 0.40) or considered the individual nutrients (OR = 0.48 to 0.56). Diabetes increased risk of posterior subcapsular, cortical, and mixed cataracts (OR = 1.56). Oral steroid therapy increased posterior subcapsular cataract risk (OR = 5.83). Females (OR = 1.51) and nonwhites (OR = 2.03) were at increased risk only for cortical cataract. Risk factors for nuclear cataract were a nonprofessional occupation (OR = 1.96), current smoking (OR = 1.68), body mass index (OR = 0.76), and occupational exposure to sunlight (OR = 0.61). Gout medications (OR = 2.48), family history (OR = 1.52), and use of eyeglasses by age 20 years, which is an indicator of myopia (OR = 1.44), increased risk of mixed cataract. The results support a role for the nutritional, medical, personal, and other factors in cataractogenesis. The potentially modifiable factors suggested by this study merit further evaluation.
Leske
M C
MC
Department of Preventive Medicine, School of Medicine, State University of New York, Stony Brook 11794-8036.
Chylack
L T
LT
Wu
S Y
SY
D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use; D016022:Case-Control Studies; D002386:Cataract / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000453:epidemiology; D004032:Diet; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012959:Socioeconomic Factors; D014815:Vitamins / Q000627:therapeutic use
D000975:Antioxidants; D014815:Vitamins