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Abstract
BackgroundIt has been suggested that the higher prevalence of cataract in women is caused by a withdrawal effect of oestrogen at menopause. In vitro studies have demonstrated protection of serum oestradiol (E2) against oxidative stress through upregulation of antioxidant enzymes, including superoxide dismutase (SOD). The purpose of the present study was to investigate E2 levels and SOD erythrocyte activity in patients with age-related cataract.MethodsThe studied subjects consisted of 103 patients with age-related cataract and 22 controls. Cataracts were classified as nuclear, cortical, or posterior subcapsular. Blood samples were collected and data on smoking, hormonal use, diabetes and age at menarche/menopause was obtained for all individuals. Serum oestradiol analyses were performed with radioimmunoassay (RIA) and SOD activity was measured in erythrocyte lysates.ResultsA negative correlation between age and E2 concentration was seen in a linear regression analysis. No correlation was seen between SOD activity and age or gender and no correlation between E2 levels and SOD activity was found using multiple linear regression. The mean level of E2 for all male subjects was 50.1 ± 16.3 pmol/L, significantly higher compared to 13.8 ± 11.8 pmol/L for postmenopausal women.ConclusionThe present study does not support a role for E2-induced effects on SOD in cataract formation. The findings of higher E2 levels in men than in postmenopausal women may suggest that decreased oestrogen at menopause is partially responsible for the gender-related difference in cataract prevalence. However, the latter can only be verified through prospective randomized trials using hormonal replacement therapy.
Highlights
It has been suggested that the higher prevalence of cataract in women is caused by a withdrawal effect of oestrogen at menopause
Men had significantly higher E2 levels compared to postmenopausal women (p < 0.001); the mean level for men in both the cataract and control group was 50.1 ± 16.3 pmol/L compared to 13.8 ± 11.8 pmol/L for postmenopausal women, a considerable difference
E2 levels and superoxide dismutase (SOD) activity for the cataract and control group are shown in Table 2, with men and women presented separately
Summary
It has been suggested that the higher prevalence of cataract in women is caused by a withdrawal effect of oestrogen at menopause. Several studies report higher prevalence of lens opacities in women as compared to men of the same age [1,2,3]. It has been proposed that with the dramatic reduction in oestradiol levels in women entering menopause, the potentially protective effects of oestrogen are withdrawn, resulting in increased risk of cataract in women. Studies have shown that earlier menarche and later menopause, causing an extended period of reproductive years, are associated with lower risk of cataract and that the use of exogenous oestrogens, i.e. hormonal replacement therapy (HRT), is associated with decreased risk of cataract. Current and longer use of HRT showed lower incidence of nuclear lens opacities in both the Beaver Dam Eye Study and the Framingham Eye Study cohort [5, 6]
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