FACTORS ASSOCIATED WITH PREVALENT LENS OPACITIES IN CHINESE AMERICAN ADULTS: THE CHINESE AMERICAN EYE STUDY

ABSTRACT

Purpose

To identify risk factors associated with lens opacities in Chinese Americans.

Methods

A cross-sectional population-based study of 4,582 Chinese Americans ≥50 years residing in Monterey Park, California. Participants completed a comprehensive clinical examination with lens assessment using the Lens Opacities Classification System II, with lens opacities defined by a grade ≥2 in either eye. Participants were considered to have nuclear-only, cortical-only, or posterior subcapsular (PSC)-only if that was the only type of opacity present in both eyes.

Results

Cortical-only opacity was associated with older age, diabetes mellitus (OR 1.5, 95%CI 1.1–2.1), and family history of cataracts (OR 1.5, 95%CI 1.2–1.9). Nuclear-only opacity was associated with older age, diabetes mellitus (OR 1.4, 95%CI 1.1–1.9), greater waist-to-hip ratio (OR 1.2, 95%CI 1.1–1.4), and high-density lipoprotein (OR 1.1, 95%CI 1.02–1.2). Mixed-type opacities were associated with older age, greater waist-to-hip ratio (OR 1.3, 95%CI 1.1–1.6), and higher HbA1 c (OR 1.3, 95%CI 1.1–1.4). Taller height (OR 0.7, 95%CI 0.6–0.8), greater weight (OR 0.98, 95%CI 0.97–0.99), and higher diastolic pressure (OR 0.98, 95%CI 0.96–0.99) were protective.

Conclusion

CHES identified a strong, dose–response association between age and all types of prevalent lens opacities, which suggests an increasing cataract burden in Chinese Americans based on aging populations. CHES results demonstrate general consistency with previous population-based studies in regard to more sedentary lifestyle exposures (e.g., Westernized lifestyle) and prevalent cortical-only, nuclear-only, and mixed-type opacities, yet also identified further sedentary lifestyle exposures associated with prevalent lens opacities. Improved glycemic control and a more active lifestyle that minimizes factors contributing to metabolic syndrome may help reduce the burden of vision loss associated with lens opacities.

KEYWORDS:

• lens opacities
• cataracts
• risk factors

Acknowledgments

The authors would like to thank the Chinese American Eye Study Data Monitoring and Oversight Committee for their advice and contributions: Alfred Sommer, MD, MHS (chair); Anne Coleman, MD, PhD; Dennis Han, MD; Craig Hanis, PhD; Louise Wideroff, PhD; Terri Young, MD.

The Chinese American Eye Study Group: Rohit Varma, MD, MPH (principal investigator); Roberta McKean-Cowdin, PhD (coinvestigator); Stanley P. Azen, PhD (coinvestigator); Mina Torres, MS (project director); Chunyi Hsu, MPH (project manager); David Dinh, BA (research assistant); Ruzhang Jiang, MD (examiner); Jie Sun, MD, PhD, MPH (examiner); Dandan Wang, MD (examiner); YuPing Wang, Certified Ophthalmic Technician (examiner); Justine Wong, BA (clinical interviewer); Shuang Wu, MS (statistician); Rucha Desai, MS (programmer).

Battelle Survey Research Center, St. Louis, Missouri: Lisa V. John, PhD (recruitment director); Michelle Cheng, MS (field supervisor).

Ocular Epidemiology Grading Center, University of Wisconsin, Madison: Stacy M. Meuer (senior grader); Ronald Klein, MD, MPH (coinvestigator).

Disclosure statement

No conflict of interest exists for any author.

Financial support

National Institutes of Health Grant U10 017337 and an unrestricted grant from the Research to Prevent Blindness, New York, New York. The sponsor or funding organization had no role in the design or conduct of this research.

Supplementary material

Supplemental data for this article can be accessed here

Notes

¹ The final adjusted model for cortical-only opacities included the following covariates: age, sex, height, family history of cataract and diabetes mellitus.

² The final adjusted model for nuclear-only opacities included the following covariates: age, sex, marital status, alcohol consumption, weight, waist-to-hip ratio, diabetes mellitus and high-density lipoprotein.

³ The final adjusted model for mixed-type opacities included the following covariates: age, sex, height, weight, waist-to-hip ratio, diastolic blood pressure, and HgA1 C.

Additional information

Funding

This work was supported by grant EY-017337 from the National Eye Institute, National Institutes of Health, Bethesda, Maryland, and an unrestricted departmental grant from Research to Prevent Blindness, New York.