Gender difference in the association of metabolic syndrome and its components with age-related cataract: the Korea National Health and Nutrition Examination Survey 2008-2010

Abstract

Purpose: To explore the relationship of the metabolic syndrome (MetS) and its components with age-related cataract in a representative Korean population.

Methods: We analyzed the data from the Korea National Health and Nutrition Examination Surveys (2008-2010). A total of 11,076 adults (4,811 men and 6,265 women) aged 40 and over who completed ophthalmologic examination were evaluated. Cataract was defined as the presence of cortical, nuclear, anterior (sub)capsular or posterior subcapsular cataract, from slit-lamp examination or previous cataract surgery. MetS was defined according to the Joint Interim Statement proposed in 2009 from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute.

Results: The prevalence of cataract and MetS in this population was 39.4% (37.1% for men and 41.6% for women) and 38.5% (37.6% for men and 39.4% for women), respectively. Cataract prevalence tended to increase with the number of MetS components in both genders (both P< 0.001). After being controlled for confounders, however, MetS was significantly associated with cataract only in women (adjusted odds ratio (aOR), 1.24; 95% confidence interval (CI), 1.02-1.50]. Reduced HDL cholesterol, elevated fasting glucose, and elevated triglycerides were also significantly associated with cataract in women (aOR, 95% CI; 1.27 (1.07-1.50), 1.23 (1.01-1.50), and 1.26 (1.04-1.52), respectively). In the subgroup analysis for cataract subtype, MetS and reduced HDL cholesterol were significantly associated with nuclear cataract in women (aOR, 95% CI; 1.25 (1.07-1.55) and 1.25 (1.03-1.52), respectively). However, such associations were not found in men.

Conclusions: Our results suggest that MetS and its components appear to be associated with age-related cataract only among Korean women, especially in nuclear cataract.

Figure 1. Prevalence of age-related cataract according to gender: by age group (A) and by the subtype of cataract (B). The error bars represent the upper 95% confidence intervals.

Figure 2. Prevalence of age-related cataract according to the increasing number of MetS components by gender.

The error bars represent the upper 95% confidence intervals. All P for trend were < 0.0001.

Figure 3. Prevalence of age-related cataract according to the absence or presence of MetS components by gender.

The error bars represent the upper 95% confidence intervals (*P<0.05, **P<0.0001).