Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

A prospective study of the relationship between body mass index and cataract extraction among US women and men

International Journal of Obesity volume 26, pages 1588–1595 (2002)Cite this article

Abstract

BACKGROUND: Obesity may influence several physiologic processes involved in cataract formation such as oxidative stress, glycosylation and osmotic stress.

OBJECTIVE: To examine the association between increased body mass index (BMI) and the incidence of cataract extraction.

DESIGN AND SETTING: The Nurses' Health Study and the Health Professionals Follow-up Study, both prospective cohort studies of US women and men.

SUBJECTS: A total of 87 682 women and 45 549 men aged 45 y and older who did not have diagnosed cataract or cancer at baseline (1980 for women, 1986 for men).

MEASUREMENTS: Cataract extractions occurring between baseline and 1996, confirmed by medical records.

RESULTS: During 16 y of follow-up in the women, and 10 y in the men, (1 097 997 person-y), 4430 incident cases were documented. Compared to participants with BMI less than 23 kg/m2, those with BMI greater than or equal to 30 kg/m2 had 36% higher risk of any type of cataract (pooled multivariate relative risk (RR), 1.36; 95% CI, 1.23–1.49) after adjusting for smoking, age and lutein/zeaxanthin intake. The association was strongest for posterior subcapsular (PSC) cataract (pooled multivariate RR, 1.99; 95% CI, 1.55–2.55). With adjustment for diabetes, the RR of obesity associated with posterior subcapsular cataract was 1.68 (95% CI, 1.30–2.17). Obesity was not significantly associated with nuclear cataract.

CONCLUSION: Obesity increases the risk of developing cataract overall, and of PSC cataract in particular; the etiology of PSC cataract may be mediated at least in part by glucose intolerance and insulin resistance, even in the absence of clinical diabetes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Clark DS, Munsell MF, Emery JM . Mathematical model to predict the need for neodymium: YAG capsulotomy based on posterior capsule opacification rate J Cataract Refract Surg 1998 24: 1621–1625.

    Article  CAS  Google Scholar 

  2. Hayashi H, Hayashi K, Nakao F, Hayashi F . Quantitative comparison of posterior capsule opacification after polymethylmethacrylate, silicone, and soft acrylic intraocular lens implantation Arch Ophthal 1998 116: 1579–1582.

    Article  CAS  Google Scholar 

  3. Hsieh WC . Review of the medical management of postoperative cataract complications J Am Optom Assoc 1998 69: 465–472.

    CAS  Google Scholar 

  4. Sundelin K, Sjostrand J . Posterior capsule opacification 5 years after extracapsular cataract extraction J Cataract Refract Surg 1999 25: 246–250.

    Article  CAS  Google Scholar 

  5. Ursell PG, Spalton DJ, Pande MV et al. Relationship between intraocular lens biomaterials and posterior capsule opacification J Cataract Refract Surg 1998 24: 352–360.

    Article  CAS  Google Scholar 

  6. Health Care Finance Administration Press Office. Press Release 1995

  7. Dorgan C . Statistical Record of Health and Medicine Gale Research Inc.: Detroit, MI 1995

    Google Scholar 

  8. Four costliest outpatient procedures Hospitals Health Netw 1997 30–31.

  9. Hankinson SE . The epidemiology of age-related cataract. In: Albert D, Jakobiec F (eds) Principles and practice of ophthalmology WB Saunders: Philadelphia, PA 1994

    Google Scholar 

  10. West SK, Valmadrid CT . Epidemiology of risk factors for age-related cataract Surv Ophthal 1995 39: 323–334.

    Article  CAS  Google Scholar 

  11. Mohan M, Sperduto RD, Angra SK et al. India–US case–control study of age-related cataracts Arch Ophthal 1989 107: 670–676.

    Article  CAS  Google Scholar 

  12. Serrano Rios M . Relationship between obesity and the increased risk of major complications in non-insulin-dependent diabetes mellitus Eur J Clin Invest 1998 28S: 14–17.

    Article  Google Scholar 

  13. Bakker SJ, Ijzerman RG, Teerlink T, Westerhoff HV, Gans RO, Heine RJ . Cytosolic triglycerides and oxidative stress in central obesity: the missing link between excessive atherosclerosis, endothelial dysfunction, and beta-cell failure? Atherosclerosis 2000 148: 17–21.

    Article  CAS  Google Scholar 

  14. Vincent HK, Powers SK, Stewart DJ, Shanely RA, Demirel H, Naito H . Obesity is associated with increased myocardial oxidative stress Int J Obes Relat Metab Disord 1999 23: 67–74.

    Article  CAS  Google Scholar 

  15. Li Y, Yan Q, Wolf NS . Long-term caloric restriction delays age-related decline in proliferation capacity of murine lens epithelial cells in vitro and in vivo Invest Ophthal Visual Sci 1997 38: 100–107.

    CAS  Google Scholar 

  16. Li Y, Yan Q, Pendergrass WR, Wolf NS . Response of lens epithelial cells to hydrogen peroxide stress and the protective effect of caloric restriction Exp Cell Res 1998 239: 254–263.

    Article  CAS  Google Scholar 

  17. Taylor A, Zuliani AM, Hopkins RE et al. Moderate caloric restriction delays cataract formation in the Emory mouse FASEB J 1989 3: 1741–1746.

    Article  CAS  Google Scholar 

  18. Hiller R, Podgor MJ, Sperduto RD et al. A longitudinal study of body mass index and lens opacities—the Framingham Studies Ophthalmology 1998 105: 1244–1250.

    Article  CAS  Google Scholar 

  19. Karasik A, Modan M, Halkin H, Treister G, Fuchs Z, Lusky A . Senile cataract and glucose intolerance: the Israel Study of Glucose Intolerance Obesity and Hypertension (The Israel GOH Study) Diabetes Care 1984 7: 52–56.

    Article  CAS  Google Scholar 

  20. Klein BE, Klein R, Moss SE . Incidence of self reported glaucoma in people with diabetes mellitus Br J Ophthal 1997 81: 743–747.

    Article  CAS  Google Scholar 

  21. Leske M, Wu S, Hennis A, Connell A, Hyman L, Schachat A . Diabetes, hypertension, and central obesity as cataract risk factors in a black population—the Barbados Eye Study Ophthalmology 1999 106: 35–41.

    Article  CAS  Google Scholar 

  22. Schaumberg DA, Glynn RJ, Christen WG, Hankinson SE, Hennekens CH . Relationships of body fat distribution and height with cataract in men Am J Clin Nutr 2000 72: 1495–1502.

    Article  CAS  Google Scholar 

  23. Goodrich ME, Cumming RG, Mitchell P, Koutts J, Burnett L . Plasma fibrinogen and other cardiovascular disease risk factors and cataract Ophthal Epidemiol 1999 6: 279–290.

    Article  CAS  Google Scholar 

  24. Mohan M, Sperduto RD, Angra SK et al. India-US case-control study of age-related cataracts Arch Ophthal 1989 107: 670–676.

    Article  CAS  Google Scholar 

  25. Leske MC, Chylack LT Jr, Wu SY . The Lens Opacities Case Control Study Group. The lens opacities case control study: risk factors for cataract Arch Ophthal 1991 109: 244–251.

    Article  CAS  Google Scholar 

  26. Willett WC, Stampfer MJ, Colditz GA et al. Dietary fat and the risk of breast cancer New Engl J Med 1987 316: 22–28.

    Article  CAS  Google Scholar 

  27. Rimm EB, Giovannucci EL, Willett WC et al. Prospective study of alcohol consumption and risk of coronary heart disease in men Lancet 1991 338: 464–468.

    Article  CAS  Google Scholar 

  28. Panel NOEIE. Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults—the Evidence Report Obes Res 1998 6: 51S–209S.

    Article  Google Scholar 

  29. Willett W, Stampfer MJ, Bain C et al. Cigarette smoking, relative weight, and menopause Am J Epidemiol 1983 117: 651–658.

    Article  CAS  Google Scholar 

  30. Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, Willett WC . Validity of self-reported waist and hip circumferences in men and women Epidemiology 1990 1: 466–473.

    Article  CAS  Google Scholar 

  31. Troy LM, Hunter DJ, Manson JE, Colditz GA, Stampfer MJ, Willett WC . The validity of recalled weight among younger women Int J Obes Relat Metab Disord 1995 19: 570–572.

    CAS  Google Scholar 

  32. Pirie P, Jacobs D, Jeffery R, Hannan P . Distortion in self-reported height and weight data J Am Diet Assoc 1981 78: 601–606.

    CAS  Google Scholar 

  33. Palta M, Prinieas RJ, Berman R, Hannan P . Comparison of self-reported and measured height and weight Am J Epidemiol 1982 115: 223–230.

    Article  CAS  Google Scholar 

  34. Brown L, Rimm EB, Seddon JM et al. A prospective study of carotenoid intake and risk of cataract extraction in US men Am J Clin Nutr 1999 70: 517–524.

    Article  CAS  Google Scholar 

  35. Chasan-Taber L, Willett WC, Seddon JM et al. A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women Am J Clin Nutr 1999 70: 509–516.

    Article  CAS  Google Scholar 

  36. Maraini G, Pasquini P, Sperduto RD et al. Risk factors for age-related cortical, nuclear, and posterior subcapsular cataracts Am J Epidemiol 1991 133: 541–553.

    Google Scholar 

  37. Mares-Perlman JA, Brady WE, Klein BE et al. Diet and nuclear lens opacities Am J Epidemiol 1995 141: 322–334.

    Article  CAS  Google Scholar 

  38. D'Agostino RB, Lee ML, Belanger AJ, Cupples LA, Anderson K, Kannel WB . Relation of pooled logistic regression to time dependent Cox regression analysis: the Framingham Heart Study Stat Med 1990 9: 1501–1515.

    Article  CAS  Google Scholar 

  39. Marshall RJ, Chisholm EM . Hypothesis testing in the polychotomous logistic model with an application to detecting gastrointestinal cancer Stat Med 1985 4: 337–344.

    Article  CAS  Google Scholar 

  40. Dubin N, Pasternack BS . Risk assessment for case-control subgroups by polychotomous logistic regression Am J Epidemiol 1986 123: 1101–1117.

    Article  CAS  Google Scholar 

  41. DerSimonian R, Laird N . Meta-analysis in clinical trials Control Clin Trials 1986 7: 177–188.

    Article  CAS  Google Scholar 

  42. Bochow TW, West SK, Azar A, Munoz B, Somemer A, Taylor HR . Ultraviolet light exposure and risk of posterior subcapsular cataracts Arch Ophthal 1989 107: 369–372.

    Article  CAS  Google Scholar 

  43. Hiller R, Sperduto RD, Podgor MJ et al. Cigarette smoking and the risk of development of lens opacities. The Framingham studies Arch Ophthal 1997 115: 1113–1118.

    Article  CAS  Google Scholar 

  44. Ford ES . Body mass index, diabetes and C-reactive protein among US adults Diabetes Care 1999 22: 1971–1977.

    Article  CAS  Google Scholar 

  45. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB . Elevated C-reactive protein levels in overweight and obese adults JAMA 1999 282: 2131–2135.

    Article  CAS  Google Scholar 

  46. Hak AE, Stehouwer CD, Bots ML et al. Associations of C-reactive protein with measures of obesity, insulin resistance, and subclinical atherosclerosis in healthy, middle-aged women Arterioscler Thromb Vasc Biol 1999 19: 1986–1991.

    Article  CAS  Google Scholar 

  47. Cushman M, Yanez D, Psaty BM et al. Association of fibrinogen and coagulation factors VII and VIII with cardiovascular risk factors in the elderly Am J Epidemiol 1996 143: 665–676.

    Article  CAS  Google Scholar 

  48. Schaumberg DA, Ridker PM, Glynn RJ, Christen WG, Dana MR, Hennekens CH . High levels of plasma C-reactive protein and future risk of age-related cataract Ann Epidemiol 1999 9: 166–171.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Supported by grants CA40356, T32 ES07069, DK46200, EY09611 and EY12269 from the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA

    JM Weintraub, WC Willett, GA Colditz, JM Seddon & SE Hankinson

  2. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA

    WC Willett

  3. Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA

    B Rosner

  4. Harvard Medical School and the Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA

    JM Seddon

  5. Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA

    JM Weintraub, WC Willett, B Rosner, GA Colditz & SE Hankinson

Authors
  1. JM Weintraub
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. WC Willett
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B Rosner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. GA Colditz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. JM Seddon
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. SE Hankinson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to JM Weintraub.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weintraub, J., Willett, W., Rosner, B. et al. A prospective study of the relationship between body mass index and cataract extraction among US women and men. Int J Obes 26, 1588–1595 (2002). https://doi.org/10.1038/sj.ijo.0802158

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802158

Keywords

This article is cited by

Search

Advanced search

Quick links