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The Shihpai Eye Study

Tung-Mei Kuang, MD, MPH; Su-Ying Tsai, PhD; Wen-Ming Hsu, MD; Ching-Yu Cheng, MD, MPH; Jorn-Hon Liu, MD; Pesus Chou, DrPH

Arch Ophthalmol. 2005;123:1109-1114.

Objective  To investigate the association between body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) and cataract in a metropolitan Asian elderly population.

Design  Population-based cross-sectional study. Age-related cataract was defined as any type of lens opacity (ie, nuclear, cortical, and posterior subcapsular opacity) with a Lens Opacities Classification System III grade of more than 2 in one or both eyes. Weight and height were measured by intensively trained interviewers.

Results  A total of 2045 subjects 65 years and older in Shihpai, Taipei, were invited to participate, and 1361 (66.6%) completed the survey. Of the subjects, 806 were diagnosed as having age-related cataracts. With a BMI of less than 21.3 as a reference point (odds ratio [OR], 1.00), a U-shaped relationship between BMI and nuclear opacity was demonstrated. A reverse U-shaped relationship was shown for cortical opacity. In the final multiple logistic regression models, BMI and BMI² were significantly related to nuclear opacity (BMI data: OR, 0.73 [95% confidence interval {CI}, 0.54-0.98]; and BMI² data: OR, 1.01 [95% CI, 1.00-1.01]) and cortical opacity (BMI data: OR, 1.52 [95% CI, 1.04-2.34]; and BMI² data: OR, 0.99 [95% CI, 0.98-0.99]). Neither BMI nor BMI² was related to posterior subcapsular opacity.

Conclusion  Body mass index is an independent risk factor for nuclear and cortical opacities, but in reverse direction to each other.

Author Affiliations: Community Medicine Research Center and Institute of Public Health (Drs Kuang, Tsai, and Chou) and Department of Ophthalmology (Drs Kuang, Hsu, Cheng, and Liu), National Yang-Ming University; Department of Ophthalmology, Taipei Veterans General Hospital (Drs Kuang, Hsu, and Cheng); Chen Hsin Medical Center (Dr Liu), Taipei; and Department of Health Management, I-Shou University, Kaoshung, Taiwan (Dr Tsai).