Association between obesity and age-related cataract: an updated systematic review and dose-response meta-analysis of prospective cohort studies

Sana Niazi; Majid Moshirfar; Mohammad H Dastjerdi; Feizollah Niazi; Farideh Doroodgar; Renato Ambrósio Jr

doi:10.3389/fnut.2023.1215212

Association between obesity and age-related cataract: an updated systematic review and dose-response meta-analysis of prospective cohort studies

Front Nutr. 2024 Jan 31:10:1215212. doi: 10.3389/fnut.2023.1215212. eCollection 2023.

Authors

Sana Niazi^{1

2}, Majid Moshirfar³, Mohammad H Dastjerdi⁴, Feizollah Niazi⁵, Farideh Doroodgar^{1

6}, Renato Ambrósio Jr^{7

8

9

10

11}

Affiliations

¹ Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran, Iran.
² Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ John A. Moran Eye Center, University of Utah, Salt Lake City, UT, United States.
⁴ Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, United States.
⁵ Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶ Negah Specialty Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁷ Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil.
⁸ Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil.
⁹ BrAIN: Brazilian Artificial Intelligence Networking in Medicine, Rio de Janeiro, Brazil.
¹⁰ Department of Ophthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil.
¹¹ Department of Ophthalmology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

Abstract

Objective: There are inconsistent findings on the association between obesity and age-related cataract (ARC). This systematic review was done to summarize available findings on the association between obesity [defined by body mass index (BMI)] and ARC by performing a dose-response meta-analysis on eligible prospective cohort studies.

Methods: We performed a systematic search in PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until June 2022 to identify eligible publications.

Results: In total, 16 studies with a total sample size of 1,607,125 participants were included. Among all of these studies, there were 103,897 cases of ARC. In the follow-up periods ranging between 4 and 28 years, 4,870 cases of nuclear cataract, 1,611 cases of cortical cataract, and 1,603 cases of posterior subcapsular cataracts (PSC) were detected. By comparing the highest and lowest categories of BMI, we found that higher BMI was associated with an increased risk of ARC (RR: 1.18, 95% CI: 1.09-1.28) and PSC (RR: 1.44, 95% CI: 1.08-1.90). In the dose-response analysis, each 5 kg/m² increase in BMI was associated with a 6 and 27% increased risk of ARC (RR: 1.06, 95% CI: 1.01-1.12) and PSC (RR: 1.27, 95% CI: 1.14-1.41), respectively. In addition, we found a positive association for cortical cataract among high-quality studies, in which higher BMI was associated with a 20% increased risk of cortical cataract (RR: 1.20, 95% CI: 1.02-1.42). In terms of nuclear cataract, we found no significant association either in the comparison between the highest and lowest categories of BMI or in the dose-response meta-analysis.

Conclusion: Obesity (defined by BMI) was associated with an increased risk of ARC, PSC, and cortical cataract in adults. However, such a positive association was not seen for nuclear cataract.

Prospero registration: CRD42022357132.

Keywords: age-related cataract; body mass index; cataract; meta-analysis; obesity.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study has been exclusively funded by the team working on it.