Weight status, abdominal adiposity, diabetes, and early age-related lens opacities

Background: The association between weight status and the risk of lens opacities has received little attention. Objective: We examined the cross-sectional relations of body mass index (BMI; in kg/m(2)), waist circumference, and diabetes with the presence of age-related lens opacities. Design: Eye examinations were conducted in 466 Boston-area women aged 53-73 y who were without previously diagnosed cataracts and were part of the Nurses' Health Study cohort. Weight, height, waist, and hip measurements were obtained by self-report. Lens status was evaluated by using the Lens Opacification Classification System III (LOCS III). BMI and waist circumference were used as measures of overweight and abdominal adiposity, respectively. Nuclear, cortical, and posterior subcapsular (PSC) opacities were defined as LOCS III scores greater than or equal to 2.5, greater than or equal to 1.0, and greater than or equal to 0.5, respectively. Diabetes was defined as a history of type 2 diabetes or as a fasting plasma glucose concentration greater than or equal to 7.0 mmol/L. Results: Women with diabetes were significantly more likely to have PSC opacities [odds ratio (OR): 4.1; 95% CI: 1.8, 9.4] than were women with fasting plasma glucose concentrations < 6.1 mmol/L. Women with a BMI greater than or equal to 30 had a higher prevalence of PSC opacities than did women with a BMI < 25 (OR: 2.5; 1.2, 5.2), and women with a waist circumference greater than or equal to 89 cm had a higher prevalence of PSC opacities than did those with a waist circumference < 80 cm (OR: 2.3; 1.0, 5.2). Diabetes and measures of adiposity were unrelated to the prevalence of cortical and nuclear opacities. Conclusions: Diabetes is a strong risk factor for PSC opacities, and overweight and abdominal adiposity may be risk factors for PSC opacities.