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C. Ngo, T. Wong, E. Liu, D. Heng, J.-M. Yuan, W.-P. Koh; A Prospective Study of Cardiovascular Risk Factors and Cataract Extraction: The Singapore Chinese Health Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4554.
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To determine the relationship between hypertension, diabetic mellitus, obesity and risk of cataract extraction in older Chinese people in Singapore.
The Singapore Chinese Health Study (SCHS) is a prospective cohort of 63,257 middle-aged and older Chinese men and women enrolled between 1993 and 1998. Information on diet, lifestyle factors and histories of medical conditions was collected through in-person interviews at baseline. Data on all cataract operations performed for "senile cataract" (ICD-9, Clinical Modification code 366.1) between 1990 and 2008 were retrieved from MediClaims, a population-based, nation-wide, government-administered medical savings fund, from which incident cases of cataract extraction among SCHS participants were identified.
There were 13,603 participants in the SCHS who underwent cataract extraction after recruitment into the cohort. In multivariate analyses, hypertension and diabetes mellitus at baseline were risk factors for cataract extraction. Hypertensive subjects were 1.10 times as likely as normotensive subjects to have cataract extraction [95% confidence interval (CI), 1.06-1.14), while diabetic subjects were 1.64 times as likely to have cataract extraction as their non-diabetic counterparts (95% CI, 1.56-1.73). Increasing body mass index (BMI) was associated with increasing risk of cataract extraction among non-diabetic subjects (P for trend < 0.001) but not among diabetic subjects (P for trend = 0.815). Hazard ratios (95% CI) of cataract extraction with BMI of ≥28 verses those <20 kg/m2 was 1.19 (95% CI, 1.09- 1.29) among non-diabetic subjects but 0.85 (95% CI, 0.68- 1.06) among diabetic subjects.
Hypertension and diabetes mellitus are associated with increased risk of cataract extraction. In addition, increased BMI is also a risk factor among non-diabetic subjects. These data suggest that patients who have hypertension, diabetes mellitus or who are obese should be screened regularly for cataract.
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