Martina Tomić1, Romano Vrabec1, Petar Raštegorac2, Spomenka Ljubić3,4, Tomislav Bulum5,6, Dario Rahelić3,4. 1. Department of Ophthalmology, Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia. 2. Division of Ophthalmology, Samobor Health Center, Samobor, Croatia. 3. Department of Diabetes and Endocrinology, Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Dugi dol 4a, 10000, Zagreb, Croatia. 4. Medical School, University of Zagreb, Zagreb, Croatia. 5. Department of Diabetes and Endocrinology, Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Dugi dol 4a, 10000, Zagreb, Croatia. tomobulum@gmail.com. 6. Medical School, University of Zagreb, Zagreb, Croatia. tomobulum@gmail.com.
Abstract
INTRODUCTION: Patients with diabetes have up to five times higher incidence of cataract, mainly at a younger age, and cataract in these patients progresses more rapidly than senile cataract, especially in eyes affected with sight-threatening diabetic retinopathy (DR). AIM: This study aimed to investigate the risk factors associated with cataract development in patients with type 2 diabetes (T2DM). METHODS: This case-control cross-sectional study included 90 T2DM (56M/34F). Metabolic risk factors glycated hemoglobin (HbA1c), total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were determined using routine laboratory methods. Blood pressure was measured with a mercury sphygmomanometer after a 10-min resting period. Lens opacity was graded according to the Lens Opacity Classification System version III (LOCS III). RESULTS: According to the LOCS III, patients were divided into two groups: group 1-patients with clear crystalline lens, and group 2-patients with initial cataract. Compared to patients with a clear crystalline lens, those with initial cataract had longer diabetes duration (p = 0.002), higher HbA1c (p = 0.037), higher total cholesterol (p = 0.029), higher diastolic blood pressure (DBP) (p = 0.014), and lower creatinine clearance (p = 0.017). Cataract was positively associated with diabetes duration (p = 0.001), HbA1c (p = 0.035), LDL cholesterol (p = 0.042), and DBP (p = 0.009), while negatively with creatinine clearance (p = 0.005). Logistic regression analysis showed that the influence of DBP (AOR = 1.06, p = 0.014) and creatinine clearance (AOR = 2.93, p = 0.045) on cataract development remained significant even after adjustment for diabetes duration and HbA1c. CONCLUSIONS: Diabetes duration and various metabolic risk factors, particularly poor glycemic control, hypercholesterolemia, DBP, and diabetic nephropathy's coexistence, are associated with cataract development in T2DM.
INTRODUCTION: Patients with diabetes have up to five times higher incidence of cataract, mainly at a younger age, and cataract in these patients progresses more rapidly than senile cataract, especially in eyes affected with sight-threatening diabetic retinopathy (DR). AIM: This study aimed to investigate the risk factors associated with cataract development in patients with type 2 diabetes (T2DM). METHODS: This case-control cross-sectional study included 90 T2DM (56M/34F). Metabolic risk factors glycated hemoglobin (HbA1c), total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were determined using routine laboratory methods. Blood pressure was measured with a mercury sphygmomanometer after a 10-min resting period. Lens opacity was graded according to the Lens Opacity Classification System version III (LOCS III). RESULTS: According to the LOCS III, patients were divided into two groups: group 1-patients with clear crystalline lens, and group 2-patients with initial cataract. Compared to patients with a clear crystalline lens, those with initial cataract had longer diabetes duration (p = 0.002), higher HbA1c (p = 0.037), higher total cholesterol (p = 0.029), higher diastolic blood pressure (DBP) (p = 0.014), and lower creatinine clearance (p = 0.017). Cataract was positively associated with diabetes duration (p = 0.001), HbA1c (p = 0.035), LDL cholesterol (p = 0.042), and DBP (p = 0.009), while negatively with creatinine clearance (p = 0.005). Logistic regression analysis showed that the influence of DBP (AOR = 1.06, p = 0.014) and creatinine clearance (AOR = 2.93, p = 0.045) on cataract development remained significant even after adjustment for diabetes duration and HbA1c. CONCLUSIONS: Diabetes duration and various metabolic risk factors, particularly poor glycemic control, hypercholesterolemia, DBP, and diabetic nephropathy's coexistence, are associated with cataract development in T2DM.
Authors: Charumathi Sabanayagam; Jie Jin Wang; Paul Mitchell; Ava Grace Tan; E Shyong Tai; Tin Aung; Seang-Mei Saw; Tien Yin Wong Journal: Invest Ophthalmol Vis Sci Date: 2011-04-14 Impact factor: 4.799
Authors: Rury R Holman; Sanjoy K Paul; M Angelyn Bethel; H Andrew W Neil; David R Matthews Journal: N Engl J Med Date: 2008-09-10 Impact factor: 91.245
Authors: Seth R Flaxman; Rupert R A Bourne; Serge Resnikoff; Peter Ackland; Tasanee Braithwaite; Maria V Cicinelli; Aditi Das; Jost B Jonas; Jill Keeffe; John H Kempen; Janet Leasher; Hans Limburg; Kovin Naidoo; Konrad Pesudovs; Alex Silvester; Gretchen A Stevens; Nina Tahhan; Tien Y Wong; Hugh R Taylor Journal: Lancet Glob Health Date: 2017-10-11 Impact factor: 26.763