Diabetes, hypertension, and central obesity as cataract risk factors in a black population - The Barbados Eye Study

Objective: The increased cataract prevalence of black populations, especial ly of cortical cataract, remains unexplained. The authors evaluate the 'rel ationships of diabetes, hypertension, and obesity patterns to lens opacitie s, by age, among 4314 black participants in the Barbados Eye Study. Design and Participants: Prevalence study of a random sample of the Barbado s population, ages 40 to 84 years (84% participation). Main Outcome Measure: Associations with age-related lens changes (grade gre ater than or equal to 2 in the Lens Opacities Classification System II at t he slit lamp) were evaluated in logistic regression analyses by age (person s <60 years and greater than or equal to 60 years), Results are presented a s odds ratios (OR) with 95% confidence intervals. Results: Of the 1800 participants with lens changes, most had cortical opac ities. Diabetes history (18% prevalence) was related to all lens changes, e specially at younger ages (age <60 years. OR = 2.23 [1.63; 3.04]; age; grea ter than or equal to 60 years: OR = 1.63 [1.22, 2.17]). Diabetes also incre ased the risk of cortical opacities (age <60 years OR = 2.30 [1.63, 3.24]; age greater than or equal to 60 years: OR = 1.42 [1.03, 1.96]); additional risk factors were high diastolic blood pressure (age <60 years: OR = 1.49 [ 1.00; 2.23]) and higher waist/hip ratio tall ages: OR = 1.36 [1.00, 1.84]). Diabetes was also related to posterior subcapsular opacities. Glycated hem oglobin levels were positively associated with cortical and posterior subca psular opacities. Overall, 14% of the prevalence of lens changes could be a ttributed to diabetes. Conclusions: The high prevalence of cortical opacities was related to diabe tes, hypertension, and abdominal obesity, which also are common in this and other black populations. Interventions to modify these risk factors, espec ially in populations in which they are highly prevalent, may have implicati ons to control visual loss from cataract, which is the first cause of blind ness worldwide.