Body Mass Index: An Independent Predictor of Cataract

doi:10.1001/archopht.1995.01100090057023

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Vol. 113 No. 9, September 1995

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Body Mass Index

An Independent Predictor of Cataract

Robert J. Glynn, ScD; William G. Christen, ScD; JoAnn E. Manson, MD; Jonathan Bernheimer; Charles H. Hennekens, MD

Arch Ophthalmol. 1995;113(9):1131-1137.

Abstract

Objective
To examine whether body mass index is an independent predictorof cataract. (Body mass index is a standardized measure definedas weight in kilograms divided by the square of the height inmeters.)

Design
Prospective cohort study, with 5 years of followup.

Participants
A total of 17 764 US male physicians participating in the Physicians'Health Study, aged 40 to 84 years, who were free of cataract,myocardial infarction, stroke, and cancer at baseline and reportedcomplete information about body mass index and other cataractrisk factors.

Main Outcome Measure
Incident cataract, defined as a self-report, confirmed by medicalrecord review, first diagnosed after randomization, age-relatedin origin, and responsible for a decrease in best correctedvisual acuity to 20/30 or worse.

Results
Incident cataract occurred during follow-up in 370 participants.In proportional hazards models that adjusted for potential confoundingvariables, body mass index had a strong, graded relationshipwith risk of cataract. Relative to those with body mass indexless than 22, relative risks (95% confidence intervals) associatedwith body mass index of 22 to less than 25, 25 to less than27.8, and 27.8 or more were 1.54 (1.04 to 2.27), 1.46 (0.98to 2.20), and 2.10 (1.35 to 3.25), respectively. Relative toany given level of body mass index, a 2-unit higher level predicteda 12% increase in risk of cataract (95% confidence interval,5% to 19%). Higher body mass index was especially strongly relatedto risk of posterior subcapsular and nuclear sclerotic cataractsand was also significantly related to risk of cataract extraction.

Conclusions
In a prospective cohort study of apparently healthy men, higherbody mass index, a potentially modifiable risk factor, was adeterminant of cataract. The leanest men had the lowest rates,consistent with experimental evidence that restriction of energyintake slows development of cataract. Although precise mechanismsare unclear, the effect of body mass index on cataractogenesisis apparently independent of other risk factors, including age,smoking, and diagnosed diabetes.

Author Affiliations

From the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (Drs Glynn, Christen, Manson, and Hennekens and Mr Bernheimer); Department of Epidemiology, Harvard School of Public Health (Dr Hennekens); and Department of Ambulatory Care and Prevention, Harvard Medical School (Dr Hennekens).

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