June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Methylenetetrahydrofolate reductase polymorphisms, serum homocysteine and incident cortical cataract
Author Affiliations & Notes
  • Ava G Tan
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Paul Mitchell
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Elena Rochtchina
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Annette Kifley
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Victoria Flood
    Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
    St.Vincent's Hospital, Sydney, NSW, Australia
  • Gyungah Jun
    Department of Medicine and Department of Ophthalmology, Boston University, Boston, MA
    Department of Biostatistics, Boston University, Boston, MA
  • Barbara E K Klein
    Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
  • Ching-Yu Cheng
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Graduate Medical School, Duke-National University of Singapore, Singapore, Singapore
  • Sudha K Iyengar
    Department of Epidemiology and Biostatistics, Case Western University, Cleveland, OH
    Department of Ophthalmology and Visual Sciences, Case Western University, Cleveland, OH
  • Jie Jin Wang
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Footnotes
    Commercial Relationships Ava Tan, None; Paul Mitchell, None; Elena Rochtchina, None; Annette Kifley, None; Victoria Flood, None; Gyungah Jun, None; Barbara Klein, None; Ching-Yu Cheng, None; Sudha Iyengar, None; Jie Jin Wang, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 6210. doi:
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    • Get Citation

      Ava G Tan, Paul Mitchell, Elena Rochtchina, Annette Kifley, Victoria Flood, Gyungah Jun, Barbara E K Klein, Ching-Yu Cheng, Sudha K Iyengar, Jie Jin Wang; Methylenetetrahydrofolate reductase polymorphisms, serum homocysteine and incident cortical cataract. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6210.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Homocysteine has been implicated as a cataractogenic stressor associated with cortical cataract formation. Methylenetetrahydrofolate reductase (MTHFR) gene is known to influence homocysteine levels, in particular the C677T polymorphism. We aimed to assess whether these two factors are associated with incident cortical cataract, and to determine the relationship between MTHFR gene, elevated homocysteine and cortical cataract.

 
Methods
 

The Blue Mountains Eye Study cohort included 2335 (75.1% of survivors) and 1952 participants (75.6% of survivors) at its second (1997-1999) and third surveys (2002-04), respectively. In this report, the second survey is the baseline and the third survey is the 5-year follow-up when incident cataract was determined. Lens photography was performed and cataract was assessed following the Wisconsin Cataract Grading system. DNA was extracted and serum homocysteine was assessed. Multi-variable adjusted logistic regression models were used to estimate the association between the MTHFR gene and elevated homocyteine on cortical cataract incidence. Path analysis was performed to assess proportion of the genetic association explained by elevated homocysteine.

 
Results
 

Elevated homocysteine was associated with a significantly increased risk of cortical cataract after adjusting for age, sex, smoking, hypertension, diabetes, education, myopia and MTHFR 677CT/TT genotype (odds ratio, OR, 1.96, 95% confidence interval, CI, 1.20-3.20). MTHFR 677CT/TT genotypes were significantly associated with incident cortical cataract after adjusting for age, sex, smoking, hypertension, diabetes, education, myopia and homocysteine (OR, 1.71, 95% CI 1.13-2.58). Path analysis showed that the direct association between the MTHFR SNP and incident cortical cataract was OR 1.42 (95% CI 1.07-1.90, beta coefficient 0.35), while the indirect association with cortical cataract via elevated homocysteine was OR 1.19 (95% CI 0.86-1.63, beta coefficient 0.17) (Figure).

 
Conclusions
 

Both the MTHFR 677CT/TT polymorphism and elevated homocysteine level significantly increased the risk of incident cortical cataract. One-third of the association between the MTHFR polymorphism and cortical cataract was explained by the influence of homocysteine.  

 
Figure. Direct and indirect pathways to incident cortical cataract
 
Figure. Direct and indirect pathways to incident cortical cataract

 
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