December 2007

 

CATARACT/ IOL

 

Connecting to MetSyn


by Matt Young EyeWorld Contributing Editor

 

 

Cataract appears to have a special link with metabolic syndrome

Cataracts are significantly related to many components of metabolic syndrome in women, and some in men as well, a new study suggests Source: Jorge L. Alio, M.D.

Cataract has often been linked to various systemic problems, but it has a special and often significant relationship with metabolic syndrome, according to new research published in a recent issue of the European Journal of Ophthalmology.

Metabolic syndrome has been linked to ischemic heart disease and cardiovascular disease mortality, but its relationship with cataract is noteworthy, as well.

“The data about relation between cataract and individual metabolic syndrome components are controversial in many studies,” wrote lead study author Alvydas Paunksnis, M.D., Institute for Biomedical Research, Laboratory of Ophthalmology, Kaunas University of Medicine, Lithuania. Nevertheless, Dr. Paunksnis did find strong associations in this research.

Relationship insight

Researchers performed an ophthalmic investigation on 1,282 respondents from 35 to 64 years old. Cataract was found in 17.6% of men and 19% of women. Metabolic syndrome was found in 19.5% of men and 25.7% of women. “A relation between cataract and metabolic syndrome was found for men aged 55 to 64 years and for women aged 45 to 64 years,” Dr. Paunksnis wrote. “The prevalence of cataract in men with metabolic syndrome was 1.3 times higher and in women with metabolic syndrome 1.4 times higher than in persons of the same age and sex without metabolic syndrome.” In men aged 45 to 64, cataract was significantly related to central obesity. In women of the same age group, cataract was significantly related to higher arterial pressure, central obesity, and elevated level of serum triglycerides.

In men aged 55 to 64, nuclear cataract was “higher than borderline level of significance” with metabolic syndrome than men without.

“In previously published scientific articles, we have not found relevant data about the relation between cataract and metabolic syndrome,” Dr. Paunksnis wrote. Research has only investigated certain components of metabolic syndrome and their link to cataract. Dr. Paunksnis concluded that metabolic syndrome components could be risk factors for cataract. Of course, these components are also age-related.

Some discrepancies did occur. For instance, in men, higher arterial blood pressure was for some reason associated with a lower incidence of cataract than in men without such blood pressure. Further, among men 45 to 54 years old, the rate of cataract was 1.5% lower for men with metabolic syndrome than those without. Dr. Paunksnis noted some discrepancies that have already existed regarding the relationship between cataract and metabolic syndrome. These include the Blue Mountains Eye Study, in which hypertension was associated with a lower incidence of nuclear cataract.

At the same time, many other studies have found a strong link between cataract and arterial hypertension. One study found that the risk of cataract surgery increased with hypertension, while another study found that it decreased. In the developed world, cataract can be operated upon with safe and effective phacoemulsification. But cataract is still the leading cause of visual impairment in all regions of the world except for the developed. Therefore, if this study’s findings are accurate, it has notable significance. That is, if metabolic syndrome can be treated effectively, many cases of early cataract around the world could be prevented, especially in women. For his part, Mark Packer, M.D., clinical associate professor, Casey Eye Institute, Oregon Health & Science University, Portland, said he also believes there’s a strong correlation between metabolic syndrome components and cataract development. “I would absolutely believe there’s a correlation,” Dr. Packer said. “If you’re set up for a heart attack, you’re more likely to get cataract at an early age.” Generally speaking though, sicker patients tend to develop cataracts at an early age, he said. Further, Dr. Packer is not sure whether there is a genetic cause for early cataract development, whether it is the result of lifestyle choices, or both. “I don’t believe cataracts cause obesity certainly,” Dr. Packer said. “That’s a stretch.”

But could cataracts be a risk factor for metabolic syndrome? Dr. Packer doesn’t know the answer to that question, and the study didn’t address that either.

Editors’ note: Dr. Paunksnis has no financial interests related to this study. Dr. Packer has no financial interests related to his comments.

Contact Information

Packer: 541-687-2110, mpacker@finemd.com

Paunksnis: apaun@medi.lt

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