Metabolic Syndrome Components and Age-Related Cataract: The Singapore Malay Eye Study

Purpose.: To examine the relationship between metabolic syndrome and its components, diabetes mellitus, high blood pressure (BP), obesity, and dyslipidemia, with age-related cataract. Methods.: A population-based sample of 2794 Malay adults aged 40 to 80 years in Singapore was used for this analysis. Cataract (n = 1268) was defined as the presence of nuclear, cortical, or posterior subcapsular (PSC) cataract, from standardized grading of lens photographs or previous cataract surgery. Metabolic syndrome was defined as the presence of ≥3 of the following components: body mass index (BMI) ≥25 kg/m2, triglycerides ≥1.7 mM, high density–lipoprotein (HDL) cholesterol <1.0 mM in men and <1.3 mM in women, BP ≥130/85 mm Hg, or use of BP medication and diabetes mellitus. Results.: Cataract prevalence increased with higher quartiles of blood glucose, systolic BP, and metabolic syndrome components (P trend < 0.0001). The multivariable odds ratio (OR) (95% confidence interval [CI]) of cataract was 1.89 (1.42–2.40) for diabetes, 1.92 (1.47–2.52) for high BP, and 1.27 (1.04–1.55) for metabolic syndrome. Of the individual metabolic syndrome components, high BP was associated with all three cataract types; diabetes was associated with cortical and PSC; low HDL, high BMI, and metabolic syndrome were associated with cortical cataract. The presence of both high BP and diabetes was associated with fourfold odds of having cataract (OR [95% CI] = 4.73 [2.16–10.34]). Conclusions.: Metabolic syndrome and its two key components, high BP and diabetes were associated with age-related cataract.