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Bruce Burkemper, Roberta McKean-Cowdin, Xuejuan Jiang, Mina Torres, Rohit Varma; Risk Factors for lens opacities in African Americans: The African American Eye Disease Study (AFEDS). Invest. Ophthalmol. Vis. Sci. 2021;62(8):77.
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© ARVO (1962-2015); The Authors (2016-present)
To determine independent risk factors (RFs) for lens opacities (LOP) in a population-based study of African Americans (AAs) ages 40 and older.
AFEDS participants, residents of Inglewood, Los Angeles County, California, completed a detailed questionnaire and comprehensive ophthalmic examination. Clinical ophthalmologists performed slit lamp exams and diagnosed LOP according to the Lens Opacities Classification System II (LOCS II). Cases were subdivided into 4 mutually exclusive categories based on opacity type present in either eye: nuclear only (NUC), cortical only (COR), post-subcapsular only (PSC) and mixed (MIX: >1 LOP type present). Multivariable logistic regression models identified factors independently associated with each LOP category (except PSC, due to too few cases).
After excluding those with bilateral cataract surgery and missing LOCS II grades, LOP among the remaining 5867 AFEDS participants were distributed as follows—NUC: 602 (10.3%), COR: 622 (10.6%), PSC: 21 (0.4%), MIX: 1386 (23.6%); 3200 subjects with no LOP in either eye were the reference group for each model. Higher waist-hip ratio (WHR) was an RF for each LOP category: after controlling for all covariates, 4th vs 1st WHR quartile subjects were 47% more likely to have NUC (OR 1.47, 95% CI 1.09-2.00), 46% more likely to have COR (OR 1.46, 95% CI 1.12-1.92), and 59% more likely to have MIX (OR 1.59, 95% CI 1.23-2.04). Older age and being unemployed were additional RFs shared among all LOP categories. Protective factors included taller height (COR) and alcohol use (NUC). Greater comorbities and smoking were additional RFs for NUC. Additional RFs for MIX included female sex, low education, diabetes, glaucoma, shorter axial length and high systolic blood pressure (alcohol use was protective, as with NUC).
AFEDS is the largest population-based study exclusively of AAs and provides a unique opportunity to identify RFs for ocular diseases such as LOP. Three RFs are common to each category of LOP examined, one of which (WHR) represents a modifiable risk factor. Factors leading to greater WHR, such as a sedentary lifestyle and poor diet, likely increase LOP risk in AAs. RFs for the most prevalent LOP category (mixed) also include high systolic blood pressure and diabetes, providing additional evidence for a link between obesity and increased LOP risk in AAs.
This is a 2021 ARVO Annual Meeting abstract.
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