Abstract
BackgroundAge-related cataract (ARC) is the leading cause of blindness in the world. The relationship between body mass index (BMI) and risk of ARC is controversial across observational studies. We therefore performed this meta-analysis to evaluate the association between BMI and risk of ARC.MethodsEligible studies were identified through an electronic search of PubMed, Embase and the Cochrane Library. We pooled study-specific relative risks (RRs) and 95% confidence intervals (CIs) to determine the risk of ARC associated with BMI categories and per 1 kg/m2 increase in BMI.ResultsA total of 17 prospective cohort studies were included in the meta-analysis. The pooled RRs of ARC were 1.08 (95% CI, 1.01–1.16) for overweight and 1.19 (95% CI, 1.10–1.28) for obesity compared with normal weight. These findings were robust when stratified by sex, sample source, outcome types and confounders, while significantly differed by assessment of BMI and ARC, and duration of follow-up. The summary RR suggested that per 1 kg/m2 increase in BMI was associated with a 2% increased risk of ARC (RR 1.02, 95% CI 1.01–1.03). Pooled estimates of RRs consistently indicated a trend for subjects with a high BMI to develop posterior subcapsular cataracts (RR 1.19, 95% CI 1.06–1.35, for overweight; RR 1.50, 95% CI 1.24–1.81, for obesity; RR 1.04, 95% CI 1.01–1.06, per 1 kg/m2 increase in BMI) other than nuclear or cortical cataracts.ConclusionsThe overall findings suggest that elevated BMI may increase the risk of ARC, especially posterior subcapsular cataracts. Further trials are needed to investigate the effect of weight reduction in obese populations on the risk of ARC.
Highlights
Age-related cataract (ARC) is a common ocular disease characterized by lens opacities and visual impairment, which develops slowly as a consequence of aging
We combined a set of search terms, truncated with wildcard characters if necessary: (‘‘cataract’’ OR ‘‘lens opacity’’ OR ‘‘cataract extraction’’ OR ‘‘cataract surgery’’) AND (‘‘body mass index’’ OR ‘‘BMI’’ OR ‘‘obesity’’ OR ‘‘adiposity’’ OR ‘‘overweight’’ OR ‘‘fat’’ OR ‘‘body weight’’) with language restricted to English
17 prospective cohort studies were included in this meta-analysis. 11 studies were eligible for the categorical relationship between BMI and ARC [4,12,15,16,17,18,29,30,31,32,33], 1 of which only evaluated nuclear cataract [18]. 7 studies were eligible for the linear relationship [10,11,12,13,34,35,36], 2 of which only reported incident nuclear cataract [13,34]
Summary
Age-related cataract (ARC) is a common ocular disease characterized by lens opacities and visual impairment, which develops slowly as a consequence of aging. Visual impairment and blindness caused by ARC remain major public health problems throughout the world [2]. A number of epidemiologic studies have identified several factors associated with an increased risk of ARC among population worldwide, such as age, smoking, alcohol consumption and ultraviolet radiation [4,5,6]. Age-related cataract (ARC) is the leading cause of blindness in the world. The relationship between body mass index (BMI) and risk of ARC is controversial across observational studies. We performed this meta-analysis to evaluate the association between BMI and risk of ARC
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