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M. Cristina Leske, MD, MPH; Suh-Yuh Wu, MA; Leslie Hyman, PhD; Robert Sperduto, MD; Barbara Underwood, PhD; Leo T. Chylack, MD; Roy C. Milton, PhD; Satish Srivastava, PhD; Naseem Ansari, PhD; The Lens Opacities Case-Control Study Group

Arch Ophthalmol. 1995;113(9):1113-1119.

Abstract
Objective
To evaluate associations with biochemical indicators of nutritional and other risk factors in the Lens Opacities Case-Control Study.

Design
Case-control study.

Setting and Participants
The Lens Opacities CaseControl Study determined risk factors for cortical, nuclear, and posterior subcapsular opacities among 1380 participants aged 40 to 79 years.

Data Collection
Vitamin E, selenium, and biochemistry profile determinations were performed on all patients; red blood cell enzymes and amino acids were measured in systematic samples of about25% of the Lens Opacities Case-Control Study population.

Outcome
Laboratory test values in cases and controls were compared and expressed as odds ratios and 95% confidence intervals.

Results
In polychotomous logistic regression analyses controlling for age and sex, the risk of opacities was reduced to less than one half in persons with higher levels of vitamin E (odds ratio, 0.44 for nuclear opacities), albumin-globulin ratio (odds ratio, 0.41 for mixed opacities), or iron (odds ratio, 0.43 for cortical opacities); higher uric acid levels increased risk (odds ratio, 1.74 for mixed opacities). Persons with opacities were twice as likely to have high glutathione reductase activity (with flavin adenine dinucleotide), which suggests low riboflavin status (odds ratio, 2.13). Most odds ratios for amino acids were under unity and were significantly decreased for glycine (0.36) and aspartic acid (0.31).

Conclusions
Lens opacities were associated with lower levels of riboflavin, vitamin E, iron, and protein nutritional status. Higher levels of uric acid increased risk of mixed opacities. The findings for riboflavin, vitamin E, iron, and uric acid are compatible with the dietary intake and medical history results of the Lens Opacities Case-Control Study.

Author Affiliations
From the Division of Epidemiology, Department of Preventive Medicine, State University of New York at Stony Brook (Drs Leske and Hyman and Ms Wu); Office of Biometry and Epidemiology, National Eye Institute, Bethesda, Md (Drs Sperduto and Milton); World Health Organization, Geneva, Switzerland (Dr Underwood); Department of Ophthalmology, Harvard Medical School and the Division of Ophthalmology, Department of Surgery, Brigham and Women's Hospital, Boston, Mass (Dr Chylack); and Division of Human Genetics, Department of Human Biological Chemistry and Genetics, University of Texas Medical Branch, Galveston (Drs Srivastava and Ansari). Members of The Lens Opacities Case-Control Study Group are listed in Archives of Ophthalmology (1991;109:251).

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