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Zhang Q, Xia X. Association between composite dietary antioxidant index and cataract in American adults aged ≥50 years: A cross-sectional study from NHANES 2003-2008. Medicine (Baltimore) 2025; 104:e42425. [PMID: 40355196 PMCID: PMC12074027 DOI: 10.1097/md.0000000000042425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Accepted: 04/24/2025] [Indexed: 05/14/2025] Open
Abstract
Oxidative stress is one of the crucial pathogeneses of cataract. The composite dietary antioxidant index (CDAI) represents the antioxidant capacity of one's diet. The aim of this study was to explore the association between the CDAI and cataract. The data were obtained from the National Health and Nutrition Examination Survey 2003 to 2008. A weighted multiple logistic regression, generalized weighted models, and smoothed fitted curves were performed to investigate the association between the CDAI and cataract. A total of 5814 participants aged ≥50 years with complete data were included in the study. According to the fully adjusted model, the odds ratio (95% confidence interval) for the association between the CDAI and cataract was 0.95 (0.93, 0.98). After dividing continuous CDAI into tertiles, consistent negative associations between CDAI and cataract were observed in the highest tertile compared to the lowest tertile (odds ratio = 0.77; 95% confidence interval, 0.62-0.95). The CDAI components (zinc, magnesium, vitamin A, and vitamin E) were also negatively associated with cataract odds in the fully adjusted model. Subgroup analysis showed inconsistent associations among subgroups, but no statistically significant interaction effects were found. This cross-sectional study revealed that a higher CDAI was associated with lower odds of cataract. These findings may contribute to cataract prevention through antioxidant dietary patterns.
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Affiliation(s)
- Quyan Zhang
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Key Specialty of Ophthalmology, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaobo Xia
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Key Specialty of Ophthalmology, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Świerczyńska M, Tronina A, Smędowski A. Understanding cataract development in axial myopia: The contribution of oxidative stress and related pathways. Redox Biol 2025; 80:103495. [PMID: 39813957 PMCID: PMC11782857 DOI: 10.1016/j.redox.2025.103495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 10/21/2024] [Accepted: 01/08/2025] [Indexed: 01/18/2025] Open
Abstract
Myopia is an evolving global health challenge, with estimates suggesting that by 2050 it will affect half of the world's population, becoming the leading cause of irreversible vision loss. Moreover, myopia can lead to various complications, including the earlier onset of cataracts. Given the progressive aging of the population and the increase in life expectancy, this will contribute to a rising demand for cataract surgery, posing an additional challenge for healthcare systems. The pathogenesis of nuclear and posterior subcapsular cataract (PSC) development in axial myopia is complex and primarily involves intensified liquefaction of the vitreous body, excessive production of reactive oxygen species, impaired antioxidant defense, and chronic inflammation in the eyeball. These factors contribute to disruptions in mitochondrial homeostasis, abnormal cell signaling, lipid peroxidation, protein and nucleic acid damage, as well as the induction of adverse epigenetic modifications. Age-related and oxidative processes can cause destabilization of crystallins with subsequent protein accumulation, which finally drives to a lens opacification. Moreover, an altered redox status is one of the major contributors to the pathogenesis of PSC. This review aims to summarize the mechanisms known to be responsible for the accelerated development of cataracts in axial myopia and to enhance understanding of these relationships.
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Affiliation(s)
- Marta Świerczyńska
- Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland; Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Agnieszka Tronina
- Department of Pediatric Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland; Department of Pediatric Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Adrian Smędowski
- Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland; Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland; GlaucoTech Co, Katowice, Poland
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Zhang J, Xiao L, Zhao X, Wang P, Yang C. Exploring the association between composite dietary antioxidant index and ocular diseases: a cross-sectional study. BMC Public Health 2025; 25:625. [PMID: 39953504 PMCID: PMC11829354 DOI: 10.1186/s12889-025-21867-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 02/10/2025] [Indexed: 02/17/2025] Open
Abstract
OBJECTIVE Globally, approximately 2.2 billion people suffer from visual impairments or blindness. Dietary patterns are closely associated with the prevalence of multiple ocular diseases. This study aimed to explore the association between Composite Dietary Antioxidant Index (CDAI) and ocular disorders. METHODS The data were derived from 1706 subjects aged 40 years and older who participated in the 2005-2008 National Health and Nutrition Examination Survey (NHANES), which utilized undersampling techniques. Trained staff interviewed participants to gather information about their dietary habits using the 24-h diet recall method. The CDAI, incorporating six antioxidants, was then computed using a validated method. Eye diseases were diagnosed through a combination of examinations and questionnaires. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders. RESULTS After adjusting for potential confounders, higher CDAI quartiles (Q4) were significantly associated with reduced odds of diabetic retinopathy (OR: 0.55, P = 0.041), cataracts (OR: 0.37, P < 0.001), glaucoma (OR: 0.48, P = 0.003), and macular degeneration (OR: 0.19, P < 0.001). Carotenoids showed a significant negative correlation with ocular diseases, diabetic retinopathy (OR: 0.57, P < 0.001), cataracts (OR: 0.75, P = 0.014), glaucoma (OR: 0.59, P < 0.001) and macular degeneration (OR: 0.55, P < 0.001). Compared to the lowest quartile (Q1), higher quartiles (Q4) of zinc intake were associated with lower odds of DR (OR: 0.32, P < 0.001) and glaucoma (OR: 0.73, P = 0.001). Similarly, Q4 of vitamin C intake were associated with lower odds of cataracts (OR: 0.70, P = 0.001) and glaucoma (OR: 0.71, P = 0.003) compared to the Q1. CONCLUSION Higher CDAI scores are correlated with a decreased odds of ocular diseases, suggesting that an antioxidant-rich dietary pattern may be associated with better ocular health. Understanding these correlations could contribute to the development of preventive strategies and intervention measures for ocular diseases.
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Affiliation(s)
- Jiechang Zhang
- Department of Cardiology, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, China
| | - Lishun Xiao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Xiujuan Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangdong, China
| | - Peiping Wang
- Department of Physical Examination, Health Management Center, The Fifth Affiliated Hospital of Sun Yat-Sen University, 52 Meihua Road, Zhuhai, 519000, China.
| | - Chengcheng Yang
- Department of Ophthalmology, The Fifth Affiliated Hospital of Sun Yat-Sen University, 52 Meihua Road, Zhuhai, 519000, China.
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Wang X, Zhang C, Jiang H. Association of dietary inflammatory index with ocular diseases: a population-based cross-sectional study. Eur J Med Res 2025; 30:62. [PMID: 39891276 PMCID: PMC11783699 DOI: 10.1186/s40001-025-02294-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 01/13/2025] [Indexed: 02/03/2025] Open
Abstract
BACKGROUND Our research was designed to investigate the relationship between dietary inflammatory index (DII) and risk of ocular diseases, including glaucoma, cataract, age-related macular degeneration (ARMD), and diabetic retinopathy. METHODS We used the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2008 to conduct this study. The correlation between DII and risk of ocular diseases was examined using weighted multivariable logistic regression analysis, restricted cubic spline (RCS) plots, and subgroup analysis. RESULTS In total, 2885 participants from the NHANES database were included. The DII scores were divided into four group: Q1 (- 4.438-0.386), Q2 (0.387-1.848), Q3 (1.849-3.073), and Q4 (3.074-4.970). RCS shown that there was a U-shaped correlation between DII and prevalence of glaucoma, cataract, ARMD, and diabetic retinopathy. After adjusting for underlying confounding variables, compared to Q1 group, the odd ratios (ORs) with 95 percent confidence intervals (CIs) for glaucoma, cataract, ARMD, and diabetic retinopathy across the quartiles were [0.97 (0.54, 1.75), 1.20 (0.68, 2.11), and 1.29 (0.73, 2.30)], [0.87 (0.56, 1.35), 1.12 (0.73, 1.73), and 1.16 (0.75, 1.80)], [0.85 (0.53, 1.36), 0.66 (0.40, 1.09), and 0.97 (0.61, 1.56)] and [0.86 (0.63, 1.18), 0.89 (0.65, 1.22), and 1.04 (0.75, 1.45)] for DII, respectively. CONCLUSIONS Reducing the intake of pro-inflammatory foods may be an effective measure to prevent the onset of ocular disease, including glaucoma, cataract, ARMD, and diabetic retinopathy. However, eating only anti-inflammatory foods is not the best choice.
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Affiliation(s)
- Xue Wang
- Department of Ophthalmology, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Zhenhua East Road, Lianyungang, 222000, Jiangsu, China.
| | - Can Zhang
- Department of Ophthalmology, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Zhenhua East Road, Lianyungang, 222000, Jiangsu, China
| | - Haitao Jiang
- Department of Ophthalmology, The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Zhenhua East Road, Lianyungang, 222000, Jiangsu, China
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Li B, Hou X, Ning B, Li X, Zhang M, Wang J, Liu M, Shi Y, Kang Z. Predictive role of the peripheral blood inflammation indices neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immunoinflammatory index (SII) for age-related cataract risk. PLoS One 2024; 19:e0313503. [PMID: 39556543 PMCID: PMC11573120 DOI: 10.1371/journal.pone.0313503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 10/24/2024] [Indexed: 11/20/2024] Open
Abstract
The novel inflammatory markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immunoinflammatory index (SII) have not yet been used in the study of age-related cataracts. The aim of this study was to investigate the possible relationships between the NLR, PLR, and SII and age-related cataracts. In the 2005-2008 National Health and Nutrition Examination Survey (NHANES) cross-sectional surveys, we collected complete information on blood counts, whether cataract surgery had been performed, and baseline information for adults. We investigated the independent interactions between the inflammatory markers NLR, PLR, and SII and age-related cataracts via weighted multivariate regression analyses and subgroup analyses. Smoothed curve fitting was performed to identify nonlinear associations and saturation effects between inflammation indices and cataract risk. Finally, receiver operating characteristic (ROC) curves were plotted for factors significantly associated with the development of cataracts to identify the optimal diagnostic inflammation index. This study included 8887 participants without cataracts and 935 participants with cataracts. Multivariate logistic regression analyses after adjusting for covariates revealed that a high SII (OR = 1.000, 95% CI = 1.000-1.000; P = 0.017) and high NLR (OR = 1.065, 95% CI = 1.000-1.134; P = 0.048) were independent risk factors for cataracts. Subgroup analyses did not reveal interactions between the SII, NLR, or cataract and covariates. Smoothed curve fits of the relationships between the SII or NLR and cataracts did not show positive significant saturating effect values for any of the variables. The ROC curve revealed some diagnostic value for cataracts for both the SII (AUC = 0.549, P < 0.001) and the NLR (AUC = 0.603, P < 0.001), but both had weak diagnostic value. Our study suggests that the SII and NLR are independent risk factors for cataracts in U.S. adults, but no such associations was identified between the PLR and cataracts.
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Affiliation(s)
- Baohua Li
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Xinyue Hou
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Bobiao Ning
- Department of Dermatology, China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, China
| | - Xiao Li
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - MingMing Zhang
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Jianquan Wang
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Mengyu Liu
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Yipeng Shi
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Zefeng Kang
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
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Zhang LP, Wei HX, Lin SH, Qiu BW, Lin JL. Cotinine exposure enhances the association of blood manganese and non-alcoholic fatty liver disease in American children: a cross-sectional study. Sci Rep 2024; 14:24593. [PMID: 39426991 PMCID: PMC11490505 DOI: 10.1038/s41598-024-75298-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 10/03/2024] [Indexed: 10/21/2024] Open
Abstract
This cross-sectional survey aims to determine whether cotinine exposure would enhance the relationship between blood manganese (Mn) and non-alcoholic fatty liver disease (NAFLD) in children using the NHANES database. Restricted cubic spline (RCS) and logistic regression analyses were adopted to determine the potential relationship. Besides, we tested the robustness of the results by performing trend tests and subgroup analyses. The study finally enrolled 866 children aged 18 years and below. Blood Mn was linearly linked to NAFLD and the risk of NAFLD was increased with the blood Mn elevation (P < 0.05). There was a notable relationship between blood Mn and NAFLD in crude model 1, which was still significant upon adjustment of all the identified covariates (all P < 0.05). Under Mn exposure, the cotinine-exposed group had a higher risk of NAFLD than the cotinine-unexposed group. In conclusion, blood Mn level is an independent risk factor for pediatric NAFLD, and cotinine exposure can enhance this relationship to some degree. Therefore, reducing cotinine exposure may alleviate detrimental consequences related to exposure to heavy metals in children.
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Affiliation(s)
- Li-Ping Zhang
- Pediatrics, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Xinluo District, Longyan, 364000, Fujian, China
| | - Hua-Xing Wei
- Pediatrics, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Xinluo District, Longyan, 364000, Fujian, China.
| | - Shi-Hui Lin
- Pediatrics, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Xinluo District, Longyan, 364000, Fujian, China
| | - Bin-Wei Qiu
- Pediatrics, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Xinluo District, Longyan, 364000, Fujian, China
| | - Jin-Liang Lin
- Pediatrics, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Xinluo District, Longyan, 364000, Fujian, China
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Liu S, Sun Q, Gu Q, Bao Y, Wang W, Qin X, Yuan X. Hypothyroidism is a causal determinant of age-related cataract risk in European population: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1254793. [PMID: 38375193 PMCID: PMC10874999 DOI: 10.3389/fendo.2024.1254793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024] Open
Abstract
Objective To determine whether there is a causal relationship between thyroid dysfunction and the risk of age-related cataract (ARC) in the European population. Design A two-sample Mendelian randomization (MR) study. Methods Hypothyroidism, hyperthyroidism, free thyroxine (fT4), and thyrotropin (TSH) were selected as exposures. The single nucleotide polymorphisms (SNP) of hypothyroidism and hyperthyroidism were obtained from the genome-wide association studies (GWAS) of the IEU database, including 337,159 subjects. Data for fT4 and TSH (72,167 subjects) were extracted from the ThyroidOmics Consortium. ARC was used as the outcome. The SNPs associated with ARC were selected from a GWAS of 216,362 individuals in the FinnGen database. The main method used was the inverse variance-weighted method, together with four complementary methods. Sensitivity analyses were performed using Cochran's Q test, MR-PRESSO, MR-Egger regression and leave-one-out test. MR pleiotropy was used to test for pleiotropy. MR Steiger test was used to test for the directionality. Results Two-sample MR analysis revealed a positive association between genetically predicted hypothyroidism and risk of ARC (OR = 2.501, 95% CI: 1.325-4.720; P = 0.004). Hyperthyroidism, circulating fT4 and TSH levels did not have a significant causal effect on ARC (P > 0.05). The results were robust and reliable, and no horizontal pleiotropy was found after sensitivity analyses. In the MR Steiger test, we found no reverse causal effects of hypothyroidism on the ARC (P <0.001). Conclusions Our study provides strong evidence that hypothyroidism is a causal determinant of ARC risk.
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Affiliation(s)
- Shu Liu
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Qi Sun
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qingwei Gu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yujie Bao
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wei Wang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaodong Qin
- Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xinran Yuan
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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