Department of Ophthalmology, Nara Medical University School of Medicine.
Department of Epidemiology, Nara Medical University School of Medicine.
Circ J. 2019 Sep 25;83(10):2044-2048. doi: 10.1253/circj.CJ-19-0118. Epub 2019 Jul 31.
Decreased light reception because of cataracts leads to potential circadian misalignment, resulting in exacerbation of atherosclerosis; however, little is known about the association between cataracts and atherosclerosis in populations.
In this cross-sectional study, cataracts were graded using slit lamp biomicroscopy with the Lens Opacities Classification System III and carotid atherosclerosis was assessed based on carotid intima-media thickness (IMT) measured using ultrasonography of the common carotid artery in 442 elderly participants (mean age, 70.0 years). Cataract was defined as nuclear cataract grade ≥3.0, cortical cataract grade ≥2.0, or posterior subcapsular cataract grade ≥2.0 in both eyes. The mean and maximal carotid IMT was 0.86±0.15 mm and 1.07±0.29 mm, respectively. In multivariable analysis adjusted for potential confounders, the mean and maximal carotid IMT were significantly greater in the cataract group than in the non-cataract group by 0.04 mm (95% confidence interval (CI), 0.01-0.06) and 0.07 mm (95% CI, 0.01-0.12), respectively. Logistic regression analysis adjusted for confounders revealed a significantly higher odds ratio for carotid atherosclerosis (maximal carotid IMT ≥1.1 mm) in the cataract group than in the non-cataract group (odds ratio, 1.78; 95% CI, 1.14-2.78).
Cataracts may be independently associated with subclinical carotid atherosclerosis in the elderly population, indicating a need for further prospective studies.
白内障导致的光照接收减少可能导致潜在的昼夜节律失调，从而加剧动脉粥样硬化；然而，人群中白内障与动脉粥样硬化之间的关联知之甚少。
在这项横断面研究中，使用裂隙灯生物显微镜和 Lens Opacities Classification System III 对白内障进行分级，通过对颈总动脉进行超声检查评估颈动脉内-中膜厚度（IMT）来评估颈动脉粥样硬化。白内障定义为双眼核性白内障分级≥3.0、皮质性白内障分级≥2.0 或后囊下白内障分级≥2.0。平均和最大颈动脉 IMT 分别为 0.86±0.15mm 和 1.07±0.29mm。在调整了潜在混杂因素的多变量分析中，与非白内障组相比，白内障组的平均颈动脉 IMT 和最大颈动脉 IMT 分别增加了 0.04mm（95%置信区间[CI]，0.01-0.06）和 0.07mm（95%CI，0.01-0.12）。调整混杂因素的逻辑回归分析显示，白内障组颈动脉粥样硬化（最大颈动脉 IMT≥1.1mm）的可能性比非白内障组高（优势比，1.78；95%CI，1.14-2.78）。
白内障与老年人亚临床颈动脉粥样硬化可能存在独立关联，表明需要进一步进行前瞻性研究。
