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Hsia NY, Tsai YY, Lin CL, Chiang CC. Increased risk of peptic ulcer in patients with early-onset cataracts: A nationwide population-based study. PLoS One 2018; 13:e0207193. [PMID: 30412615 PMCID: PMC6226190 DOI: 10.1371/journal.pone.0207193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 10/28/2018] [Indexed: 01/19/2023] Open
Abstract
Early-onset cataracts (EOC) are associated with an increased inflammatory response; therefore, a potential risk of other inflammatory diseases, like peptic ulcer, may be related. This study investigated the risk of peptic ulcer after being diagnosed with EOC. Retrospective claims data from the Taiwan National Health Insurance Research Database were analyzed. Study subjects comprised patients with EOC (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9- CM] codes 366.00, 366.01, 366.02, 366.03, 366.04, 366.09, 366.17 and 366.18), aged 20–55 years and newly diagnosed between 2000 and 2010 (n = 1910), and a comparison cohort without the disease (n = 7515). Both cohorts were followed up until 2010 to estimate the incidences of peptic ulcer. We used the Poisson regression model to compare incidence rate ratios and the 95% confidence interval (CI). Cox proportional hazards regression was used to assess the hazard ratio (HR) of peptic ulcer associated with EOC. The overall incidence rate of peptic ulcer was higher in the EOC cohort than in the comparison cohort (10.3 vs 7.68 per 1000 person-years) with an adjusted HR of 1.33 (95% CI = 1.05, 1.69). The present study suggests that patients with EOC are at an increased risk of being diagnosed with peptic ulcer in subsequent years.
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Affiliation(s)
- Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University College of Medicine, Taichung, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University College of Medicine, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan
| | - Chun-Chi Chiang
- Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University College of Medicine, Taichung, Taiwan
- * E-mail:
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Huang CY, Chen TS, Lin CL, Hu WS. Does early onset cataract increase the risk of ischemic stroke? A nationwide retrospective cohort study. Intern Emerg Med 2017; 12:461-465. [PMID: 28005263 DOI: 10.1007/s11739-016-1591-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 12/10/2016] [Indexed: 10/20/2022]
Abstract
This study was attempted to address the association between early onset cataract (EOC) and ischemic stroke. Using the Longitudinal Health Insurance Database 2000, we established an EOC cohort and a comparison cohort by using 4-fold propensity score matching according to age, gender and comorbidities to detect the incidence of ischemic stroke. A Cox model was used to express the risk of ischemic stroke for the EOC patients compared with the comparison cohort. After adjusting for age, gender and comorbidities of hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, asthma, chronic obstructive pulmonary disease, chronic kidney disease, heart failure, obesity, and atrial fibrillation, the EOC patients had a 1.48-fold higher risk of ischemic stroke than the comparison cohort, but it was not statistically significant. A non-significant increase in the risk of subsequent ischemic stroke development for the EOC patients is demonstrated in this study.
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Affiliation(s)
- Chih-Yang Huang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, 40402, Taiwan
- Department of Health and Nutrition Biotechnology, Asia University, Taichung, 41354, Taiwan
| | - Tung-Sheng Chen
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, 40402, Taiwan
- Biomaterials Translational Research Center, China Medical University Hospital, Taichung, 40402, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan
| | - Wei-Syun Hu
- School of Medicine, College of Medicine, China Medical University, Taichung, 40402, Taiwan.
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan.
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Hu WS, Lin CL. Association Between Cataract and Risk of Incident Atrial Fibrillation: A Nationwide Population-Based Retrospective Cohort Study. Mayo Clin Proc 2017; 92:370-375. [PMID: 27902443 DOI: 10.1016/j.mayocp.2016.08.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/15/2016] [Accepted: 08/26/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To identify the association between cataract and the subsequent atrial fibrillation (AF) risk. PATIENTS AND METHODS Our retrospective cohort study was designed to analyze the Longitudinal Health Insurance Database 2000 of the Taiwan National Health Insurance program. We established a cataract cohort (n=39,347) and a noncataract cohort (n=39,347) to observe the incidence of AF. The cataract cohort included patients who were newly diagnosed with cataract from January 1, 2000, to December 31, 2010. Propensity score matching was used to form matched sets of participants with cataract and participants without cataract who share a similar value of propensity score. Univariable and multivariable Cox proportional hazards regression models were used to assess the association between having a cataract and AF. RESULTS The median (range) follow-up period was 6.52 years (range, 3.76-9.19 years) and 5.88 years (range, 3.12-8.66 years) for the cataract and noncataract cohorts, respectively; the cumulative incidence curves of AF indicated that the cataract cohort had a significantly higher risk of developing AF than did the noncataract cohort (P<.001). Moreover, the risk of AF was 1.32-fold (95% CI, 1.18-1.48) higher in patients with cataract with surgery and was 1.21-fold (95% CI, 1.06-1.37) higher in patients with cataract without surgery than in patients without cataract. CONCLUSION The present study is the first to report that cataract is associated with an increased risk of AF.
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Affiliation(s)
- Wei-Syun Hu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan.
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
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Wasserman H, Hufnagel RB, Miraldi UV, Zhang K, Valencia CA, Leslie ND, Crimmins NA. Bilateral cataracts in a 6-yr-old with new onset diabetes: a novel presentation of a known INS gene mutation. Pediatr Diabetes 2016; 17:535-539. [PMID: 26530398 PMCID: PMC4854816 DOI: 10.1111/pedi.12335] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 10/01/2015] [Accepted: 10/06/2015] [Indexed: 01/12/2023] Open
Abstract
The prevalence of diabetes-related cataracts during childhood is less than 1%. When cataracts occur, it is often in adolescent females with prolonged symptoms and significant hyperglycemia. Cataracts are not a classic feature of monogenic diabetes. We report a case of a 6-yr-old, previously healthy Caucasian male, who presented with bilateral acquired cataracts and was subsequently diagnosed with new onset diabetes. Additional symptoms at presentation included a several year history of polyuria and polydipsia, mild hepatomegaly, and short stature. Pertinent negatives include acanthosis nigricans, lipoatrophy, deafness, muscle weakness, or neuropathy. HbA1c was significantly elevated at diagnosis (>14%, 129.5 mmol/mol) without evidence of ketosis. Autoantibody testing was negative. Features of Mauriac syndrome (short stature, hepatomegaly) as well as acquired cataracts indicated long-standing hyperglycemia with sufficient insulin production to prevent ketone production and development of diabetic ketoacidosis. Whole exome sequencing was conducted and a de novo heterozygous mutation in the INS gene (c.94G>A; p.Gly32Ser) was identified. INS gene mutations are common causes of permanent neonatal diabetes but rare causes of antibody-negative diabetes in children. Importantly, INS gene mutations have not been previously associated with acquired cataracts. Knowledge of a monogenic cause of diabetes allows clinicians to tailor counseling and screening of diabetes-related comorbidities. In summary, this case highlights the need to consider testing for monogenic diabetes, specifically INS gene mutations, in pediatric patients with antibody-negative diabetes, especially if complications of prolonged hyperglycemia are present at diagnosis.
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Affiliation(s)
- H Wasserman
- Cincinnati Children’s Hospital Medical Center Division of Endocrinology 3333 Burnet Ave MLC 7012, Cincinnati, Ohio 45229
| | - RB Hufnagel
- Cincinnati Children’s Hospital Medical Center Division of Human Genetics 3333 Burnet Ave MLC 4006, Cincinnati, Ohio 45229
| | - Utz V Miraldi
- Cincinnati Children’s Hospital Medical Center Department of Ophthalmology 3333 Burnet Ave MLC 4008, Cincinnati, Ohio 45229
| | - K Zhang
- Cincinnati Children’s Hospital Medical Center Division of Human Genetics 3333 Burnet Ave MLC 4006, Cincinnati, Ohio 45229
| | - CA Valencia
- Cincinnati Children’s Hospital Medical Center Division of Human Genetics 3333 Burnet Ave MLC 4006, Cincinnati, Ohio 45229
| | - ND Leslie
- Cincinnati Children’s Hospital Medical Center Division of Human Genetics 3333 Burnet Ave MLC 4006, Cincinnati, Ohio 45229
| | - NA Crimmins
- Cincinnati Children’s Hospital Medical Center Division of Endocrinology 3333 Burnet Ave MLC 7012, Cincinnati, Ohio 45229
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Hu WS, Lin CL, Chang SS, Chen MF, Chang KC. Increased risk of ischemic heart disease among subjects with cataracts: A population-based cohort study. Medicine (Baltimore) 2016; 95:e4119. [PMID: 27428198 PMCID: PMC4956792 DOI: 10.1097/md.0000000000004119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Association between cataract and the risk of ischemic heart disease (IHD) development is not completely clear. PURPOSE The primary aim of the study was to evaluate the association between cataract and the risk of incident IHD. The secondary aim was to investigate the subsequent IHD risk of patients with cataracts undergoing cataract surgery. METHODS Retrospective data from the Longitudinal Health Insurance Database 2000 (LHID2000) was analyzed. Study participants were composed of patients with cataracts (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 366) (n = 32,456), and a comparison cohort without the cataracts (n = 32,456) from 2000 to 2010. Cox proportional hazards regression was used to address the hazard ratio (HR) of IHD associated with cataract. RESULTS Within 12 years of follow up, the overall incidence rates of IHD were 24.2 per 1000 person-years in the cataract cohort and 18.2 per 1000 person-years in the noncataract cohort with an adjusted hazard ratio (aHR) of 1.35 (95% CI = 1.29-1.41; P < 0.001). Furthermore, the cataract patients undergoing cataract surgery were associated with a higher risk of IHD compared with those cataract patients without surgery (aHR = 1.07, 95% CI: 1.01-1.14; P < 0.05). CONCLUSIONS Our finding suggested that patients with cataracts are at an increased risk of subsequent IHD development.
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Affiliation(s)
- Wei-Syun Hu
- School of Medicine, College of Medicine, China Medical University
- Division of Cardiovascular Medicine, Department of Medicine
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital
| | - Shih-Sheng Chang
- School of Medicine, College of Medicine, China Medical University
- Division of Cardiovascular Medicine, Department of Medicine
| | - Ming-Fong Chen
- School of Medicine, College of Medicine, China Medical University
- Division of Cardiovascular Medicine, Department of Medicine
| | - Kuan-Cheng Chang
- School of Medicine, College of Medicine, China Medical University
- Division of Cardiovascular Medicine, Department of Medicine
- Graduate Institute of Clinical Medical Science, China Medical University
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
- Correspondence: Kuan-Cheng Chang, Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital 2, Yuh-Der Road, Taichung 40447, Taiwan (e-mail: )
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Cataract increases the risk of peripheral artery occlusive disease: A nationwide population-based cohort study with propensity score. Int J Cardiol 2016; 220:768-71. [PMID: 27393864 DOI: 10.1016/j.ijcard.2016.06.084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/15/2016] [Accepted: 06/21/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE We conducted this study to evaluate the risk of peripheral artery occlusive disease (PAOD) among patients with cataracts. METHODS We analyzed the data from Taiwan National Health Insurance Research Database. Study participants were classified into the cataract group and the non-cataract group between 2000 and 2010. All patients were observed from the index year until PAOD diagnosis, loss to follow up, or the end of 2011. Both study groups were 1:1 matching based upon a propensity score. We used a cox proportional hazards regression model to assess the hazard ratio (HR) and 95% confidence interval (CI) of PAOD for the cataract cohort compared with the non-cataract cohort. RESULTS After adjustment for age, sex and comorbidities, the risk of PAOD was significantly higher in the cataract cohort [adjusted HR (aHR)=1.48, 95% CI=1.38-1.58] than the non-cataract cohort. CONCLUSIONS We found that patients with cataracts had a 1.48-fold increased risk of developing PAOD compared to the non-cataract patients.
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Iafusco D, Prisco F, Romano MR, Dell'omo R, Libondi T, Costagliola C. Acute juvenile cataract in newly diagnosed type 1 diabetic patients: a description of six cases. Pediatr Diabetes 2011; 12:642-8. [PMID: 21477105 DOI: 10.1111/j.1399-5448.2010.00749.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Cataract represents one of the most frequent eye complications in type 1 and type 2 patients; contrarily, acute cataract in young diabetic patients occurs very rarely. The aim of this study was to describe six cases of acute cataract in adolescents at the onset of type 1 diabetes. Eight hundred and twenty-six patients with type 1 diabetes were retrospectively studied. A multivariate analysis was applied to verify the weight of the following laboratory findings taken on admission (independent variables): glycemia, glycated hemoglobin (HbA1c), pH, base excess (BE),and on the occurrence of cataract (dependent variable). Six patients (0.7%) presented with acute lens opacities. Cataract development was significantly correlated with HbA1c and glycemia. The relative risk increases about twice for each percentage point from 12.8 to 14.1% of HbA1c; glycemic blood levels represent a moderate risk factor for cataractogenesis. Ketoacidosis and BE were not significantly correlated.
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Affiliation(s)
- Dario Iafusco
- Department of Pediatrics, Second University of Naples, Naples, Italy
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Associations between hearing impairment and mortality risk in older persons: the Blue Mountains Hearing Study. Ann Epidemiol 2010; 20:452-9. [PMID: 20470972 DOI: 10.1016/j.annepidem.2010.03.011] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 01/27/2010] [Accepted: 03/07/2010] [Indexed: 11/21/2022]
Abstract
PURPOSE To assess whether hearing loss predicts an increased risk of mortality. METHODS The Blue Mountains Hearing Study examined 2956 persons (49+ years) during 1997 to 2000. The Australian National Death Index was used to identify deaths until 2005. Hearing loss was defined as the pure-tone average (0.5-4 kHz) of air-conduction hearing thresholds greater than 25 dB HL. Associations between hearing loss and mortality risk were estimated using Cox regression and structural equation modeling (SEM). RESULTS When we used Cox regression, we discovered that hearing loss was associated with increased risk of cardiovascular (hazard ratio [HR] 1.36, 95% confidence interval [CI] 1.08-1.84) and all-cause (AC) mortality (HR 1.39, 95% CI 1.11-1.79) after adjustment for age and sex but not after multivariable adjustment. SEM pathway analysis, however, revealed a greater AC mortality risk (HR 2.58, 95% CI 1.64-4.05) in persons with hearing loss, which was mediated: cognitive impairment (HR 1.45, 95% CI 1.08-1.94) and walking disability (HR 1.63, 95% CI 1.24-2.15). These variables increased mortality both directly and indirectly through effects on self-rated health. CONCLUSIONS Hearing loss was associated with increased AC mortality via three mediating variables: disability in walking, cognitive impairment, and self-rated health. It is important to recognize that persons with combined disabilities are at increased risk of cardiovascular and AC mortality.
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Christen WG, Glynn RJ, Ajani UA, Schaumberg DA, Manson JE, Buring JE, Hennekens CH. Baseline self-reported cataract and subsequent mortality in Physicians' Health Study I. Ophthalmic Epidemiol 2009. [DOI: 10.1076/0928-6586(200006)721-zft115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pedula KL, Coleman AL, Hillier TA, Ensrud KE, Nevitt MC, Hochberg MC, Mangione CM. Visual acuity, contrast sensitivity, and mortality in older women: Study of osteoporotic fractures. J Am Geriatr Soc 2007; 54:1871-7. [PMID: 17198492 DOI: 10.1111/j.1532-5415.2006.00983.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether poorer visual acuity and contrast sensitivity are independent risk factors for all-cause and traumatic mortality in older women. DESIGN Twelve-year prospective cohort study (1986-2003). SETTING Four U.S. clinical centers. PARTICIPANTS Nine thousand seven hundred four postmenopausal white women aged 65 and older. MEASUREMENTS Habitually corrected binocular visual acuity and low- and high-frequency contrast sensitivity were measured at baseline using a standard protocol. A study physician adjudicated the primary cause of death from death certificates and medical record review. RESULTS During an average of 12.2 years of follow-up, 3,427 women died (35%), 72 (0.7%) from traumatic events. In multivariate models adjusted for age, chronic medical problems, and smoking, all-cause mortality risk was 19% greater for persons in the worst quartile of visual acuity than for those in the best (hazard ratio (HR) = 1.19, P = .008) and 39% greater for persons with the worst contrast sensitivity (HR = 1.39, P < .001) than for those with the best. Traumatic mortality risk was 2.4 times greater for women with the worst contrast sensitivity than for those with the best (HR = 2.44, P = .03). CONCLUSION Poorer visual acuity and contrast sensitivity are associated with greater risk of traumatic and all-cause mortality in older women, even after controlling for demographic and clinical characteristics. Although further research is necessary to determine how treating reversible causes of visual impairment or improving current refraction affects mortality in older women, clinical detection and follow-up of these visual impairments holds promise for identifying those who are at risk of mortality from other systemic conditions.
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Affiliation(s)
- Kathryn L Pedula
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon 97227, USA.
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Abstract
Diabetes mellitus, especially type 2 diabetes, is a growing concern in America. Longitudinal trends show that obesity is more prevalent than in the past, and the incidence of type 2 diabetes is also increasing. Type 2 diabetes typically doubles the CHD risk in men and triples the risk in women. Intervening to control lipid levels and blood pressure has been shown to be especially helpful in preventing CHD, but the impact of better glycemic control on CHD risk is less convincing, especially in clinical trials. Revascularization studies in diabetics show that coronary bypass surgery is related to better outcomes than angioplasty procedures.
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Affiliation(s)
- P W Wilson
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
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Hennis A, Wu SY, Li X, Nemesure B, Leske MC. Lens opacities and mortality : the Barbados Eye Studies. Ophthalmology 2001; 108:498-504. [PMID: 11237904 DOI: 10.1016/s0161-6420(00)00542-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate the association between cataract and mortality in a black population by type of opacity, which has not been documented previously. DESIGN Population-based cohort study. PARTICIPANTS The Barbados Incidence Study of Eye Diseases reexamined the Barbados Eye Study cohort, identified through a simple random sample of predominantly black Barbadian-born citizens, aged 40 to 84 years. Of those eligible, 85% (3427 participants) had a 4-year follow-up visit. METHODS Baseline and follow-up visits included an interview, blood pressure and other measurements, and a detailed ophthalmologic examination with slit-lamp lens gradings (Lens Opacities Classification System [LOCS] II protocol). Mortality at follow-up was verified from Ministry of Health records. MAIN OUTCOME MEASURES Lens opacities were defined by a LOCS II score of 2 or more. Opacity types were classified in two ways: (1) single (cortical-only, nuclear-only, and posterior subcapsular-only) and mixed opacities; and (2) any cortical, any nuclear, or any posterior subcapsular opacities. Information on dates and causes of death was obtained from death certificates. RESULTS Cardiovascular disease was the principal cause of death in black participants (3.6%), followed by malignant neoplasms (1.4%). The cumulative 4-year mortality varied with lens types, increasing from 3.2% for those without cataract to 6.0% for cortical-only, 8.8% for nuclear-only, and 20.9% for mixed opacities. Persons with mixed opacities had a 1.6-fold increase in mortality, while controlling for other factors (age, male gender, diabetes, hypertension, obesity, cigarette smoking, cardiovascular disease, and family history of diabetes) in Cox proportional-hazards regression analyses. Persons with any nuclear opacities also had increased mortality (death rate ratio, 1.5). The death rate ratios increased with age, but peaked at age 60 to 69 years. Coexisting diabetes further increased mortality: people with mixed opacities and diabetes had a 2.7-fold increased risk of death. A trend toward increased mortality from neoplasms was observed for individuals with mixed opacities or with any nuclear opacities. CONCLUSIONS Participants with mixed opacities or any nuclear opacities had increased 4-year mortality rates, with diabetes acting as an effect modifier. This study is the first to identify a relationship between type of cataract and mortality in an African-descent population.
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Affiliation(s)
- A Hennis
- School of Clinical Medicine and Research, University of the West Indies, Barbados, West Indies
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Goodrich ME, Cumming RG, Mitchell P, Koutts J, Burnett L. Plasma fibrinogen and other cardiovascular disease risk factors and cataract. Ophthalmic Epidemiol 1999; 6:279-90. [PMID: 10544342 DOI: 10.1076/opep.6.4.279.4188] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine whether associations exist between cataract and established cardiovascular risk factors (other than smoking) - hypertension, body mass index, serum lipids and plasma fibrinogen. METHODS The Blue Mountains Eye Study is a large (n=3654) population-based cross-sectional study conducted among people aged 49-97 years residing in the Blue Mountains, a region west of Sydney, Australia. Risk factor data were collected using standardised clinical procedures. Lens photographs were taken and graded for presence and severity of cortical, nuclear, and posterior subcapsular cataracts. RESULTS Cortical cataract was associated with a history of myocardial infarction, higher plasma fibrinogen, and higher serum cholesterol. Nuclear cataract was associated with a higher platelet count but hypertension was associated with lower prevalence of nuclear cataract. Posterior subcapsular cataract was associated with higher plasma fibrinogen and lower body mass index. Some of these associations appeared to be stronger in women than in men: fibrinogen and cortical cataract and body mass index and posterior subcapsular cataract. CONCLUSIONS Several risk factors for cardiovascular disease are associated with presence of cataract, perhaps explaining the observation in several studies that people with cataract have increased mortality rates. The possibility of strong associations between plasma fibrinogen and cataract merits further epidemiological and laboratory research.
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Affiliation(s)
- M E Goodrich
- University of Sydney, Department of Ophthalmology, Sydney, Australia
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14
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Hiller R, Podgor MJ, Sperduto RD, Wilson PW, Chew EY, D'Agostino RB. High intraocular pressure and survival: the Framingham Studies. Am J Ophthalmol 1999; 128:440-5. [PMID: 10577585 DOI: 10.1016/s0002-9394(99)00187-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To examine whether high intraocular pressure (greater than or equal to 25 mm Hg) or a history of treatment for glaucoma is associated with decreased survival and, if so, how such ocular markers might be explained. METHODS Eye examinations, including applanation tonometry, were conducted on members of the Framingham Eye Study cohort from February 1, 1973, to February 1, 1975. Participants who reported a history of treatment for glaucoma were identified. Survival data, including information on the date of death, were available from the time of the Eye Study through March 31, 1990. RESULTS Of the 1,764 persons under the age of 70 years at the baseline eye examination, 1,421 persons had low intraocular pressure (< or =20 mm Hg), 264 persons had medium intraocular pressure levels (20 to 24 mm Hg), and 79 persons had high intraocular pressure (> or =25 mm Hg) or history of glaucoma treatment. During the follow-up period, 29%, 30%, and 47% died in the groups with low, medium, and high intraocular pressure (or history of glaucoma treatment), respectively. In an age-and-sex adjusted Cox proportional hazards analysis, the death rate ratio for the group with medium intraocular pressure relative to the group with low intraocular pressure was 1.04. The corresponding death rate ratio for the group with high intraocular pressure was 1.56 with a 95% confidence interval of 1.11 to 2.19 (P < .001). After adjustment for age, sex, hypertension, diabetes, cigarette smoking, and body mass index, a positive relationship remained, but at a borderline level of significance (P = .075). CONCLUSIONS High intraocular pressure or the presence of glaucoma is a marker for decreased life expectancy in the Framingham Eye Study cohort. The relationship is present even after adjustment for risk factors known to be associated with higher mortality such as age, sex, hypertension, diabetes, cigarette smoking, and body mass index. Special attention to the general health status of patients with high intraocular pressure or glaucoma seems warranted.
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Affiliation(s)
- R Hiller
- Division of Biometry and Epidemiololgy, National Eye Institute, Bethesda, Maryland 20892-2510, USA
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Grundy SM, Balady GJ, Criqui MH, Fletcher G, Greenland P, Hiratzka LF, Houston-Miller N, Kris-Etherton P, Krumholz HM, LaRosa J, Ockene IS, Pearson TA, Reed J, Washington R, Smith SC. Primary prevention of coronary heart disease: guidance from Framingham: a statement for healthcare professionals from the AHA Task Force on Risk Reduction. American Heart Association. Circulation 1998; 97:1876-87. [PMID: 9603549 DOI: 10.1161/01.cir.97.18.1876] [Citation(s) in RCA: 324] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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16
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Klein BE, Klein R, Lee KE. Cardiovascular disease, selected cardiovascular disease risk factors, and age-related cataracts: the Beaver Dam Eye Study. Am J Ophthalmol 1997; 123:338-46. [PMID: 9063243 DOI: 10.1016/s0002-9394(14)70129-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To examine the associations of cardiovascular disease and selected cardiovascular disease risk factors with the prevalence of age-related cataract. METHODS We conducted a population-based prevalence study of adults aged 43 to 86 years (n = 4,926) in Beaver Dam, Wisconsin. An ocular examination including lens photographs, medical history, height and weight measurement, blood testing, and photograph grading was performed according to standard protocols. RESULTS Age and sex influenced most of the relationships between risk variables and cataract. Many relationships apparent in univariate analyses were not significant when controlling for confounders. In multivariate models, higher glycated hemoglobin was significantly and consistently associated with increased risk of nuclear cataract in women. For cortical cataract, higher serum high density lipoprotein cholesterol was associated with decreased risk in women. For posterior subcapsular cataract, men with higher ratios of total to high-density lipoprotein cholesterol were at increased risk. History of cardiovascular disease was not associated with cataracts in persons with or without diabetes after controlling for additional risk indicators. CONCLUSIONS Some risk factors for cardiovascular disease were associated with increased frequency of age-related lens opacities. Age and sex influenced these relationships but did not entirely explain them. Longitudinal follow-up is necessary to determine antecedent-consequent relationships that may suggest causal associations.
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Affiliation(s)
- B E Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison 53705-2397, USA
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Gollamudi SR, Smiddy WE, Schachat AP, Michels RG, Vitale S. Long-term survival rate after vitreous surgery for complications of diabetic retinopathy. Ophthalmology 1991; 98:18-22. [PMID: 2023726 DOI: 10.1016/s0161-6420(91)32349-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The survival rate after vitreous surgery for complications of diabetic retinopathy was studied in 552 consecutive patients who underwent operations between 1979 and 1984. The 5-year postoperative survival rate was 74.7%. Factors associated with a lower survival rate included older age, older age at diagnosis of diabetes, history of renal disease, and a longer duration of diabetes. Factors unrelated to survival rate included insulin treatment, sex, and anatomic and visual outcome. Improved management of systemic diabetic complications has improved survival rates, a finding reflected in the relatively high rate of long-term survival after diabetic vitrectomy.
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Affiliation(s)
- S R Gollamudi
- Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore
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Abstract
A population-based cohort of 294 diabetic patients were examined for the presence of lens opacities and followed up for a median of 6 years. Only two patients were lost to follow-up but there were 73 deaths, 49 in the 108 patients with opacities and 24 in the 184 patients without (odds ratio 2.4, 95% Cl 1.5-3.9). Lens opacities were a powerful predictor of death and the effect was independent of other prognostic factors. The presence of cataract identifies a high risk sub-group of elderly diabetic patients.
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Affiliation(s)
- D L Cohen
- Department of Geriatric Medicine, Radcliffe Infirmary, Oxford, UK
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