ETH Zurich, Department of Chemistry and Applied Biosciences, Zurich, Switzerland.
Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Surg Obes Relat Dis. 2022 Feb;18(2):217-224. doi: 10.1016/j.soard.2021.10.021. Epub 2021 Nov 5.
Obesity is considered a risk factor for cataracts. The association between weight loss and a cataract among patients with obesity has not been assessed to date.
To assess the association between weight loss following bariatric surgery and cataracts.
Nationwide Swedish healthcare registries between 2006 and 2019.
We performed a population-based cohort study. Patients aged 40-79 years who underwent bariatric surgery were matched on their propensity score (PS) to up to 2 patients with obesity ("unexposed patients"). Cox proportional hazard regression analyses calculated hazard ratios (HRs) and 95% confidence intervals (CIs) of developing cataracts following bariatric surgery, compared with unexposed patients. Subgroup analyses by age, sex, bariatric surgery type, and duration of follow-up were conducted.
In total, 22,560 bariatric surgery patients were PS-matched to 35,523 unexposed patients. The risk of cataracts was decreased in bariatric surgery patients compared with unexposed patients (HR .71, 95% CI .66-.76). We observed the lowest risk of cataracts among bariatric surgery patients aged 40-49 years (HR .52, 95% CI .44-.75) but a null result for patients aged ≥60 years. Gastric bypass or duodenal switch were associated with decreased risks of cataracts, whereas sleeve gastrectomy yielded a null result. Subgroups of sex and duration of follow-up showed no evidence of effect modification (hazards were proportional throughout follow-up).
Our results suggest that substantial weight loss following bariatric surgery is associated with a decreased risk of cataracts, especially if bariatric surgery was performed before age 60.
肥胖被认为是白内障的一个风险因素。迄今为止，尚未评估肥胖患者减肥与白内障之间的关系。
评估减肥与减肥手术后白内障之间的关联。
2006 年至 2019 年期间，全国范围内的瑞典医疗保健登记处。
我们进行了一项基于人群的队列研究。年龄在 40-79 岁之间接受减肥手术的患者根据倾向评分（PS）与多达 2 名肥胖患者（“未暴露患者”）进行了匹配。使用 Cox 比例风险回归分析计算了减肥手术后与未暴露患者相比发生白内障的风险比（HR）和 95％置信区间（CI）。进行了年龄，性别，减肥手术类型和随访时间的亚组分析。
共有 22560 名减肥手术患者与 35523 名未暴露患者进行了 PS 匹配。与未暴露患者相比，减肥手术患者的白内障风险降低（HR.71，95％CI.66-.76）。我们观察到 40-49 岁的减肥手术患者的白内障风险最低（HR.52，95％CI.44-.75），但≥60 岁的患者则无结果。胃旁路术或十二指肠转流术与白内障风险降低相关，而袖状胃切除术则无结果。性别和随访时间的亚组均未显示出效应修饰的证据（整个随访期间风险是成比例的）。
我们的结果表明，减肥手术后大量减肥与白内障风险降低有关，尤其是如果在 60 岁之前进行减肥手术。
