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Relations of body fat distribution and height with cataract in men^1,2,3

¹ From the Division of Preventive Medicine and the Channing Laboratory of the Brigham and Women's Hospital, Harvard Medical School, and the Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Boston.

Background: Cataract is the leading cause of blindness worldwide. Body mass index (BMI; in kg/m²) is a risk factor for cataract, but other anthropometric measurements may also be important.

Objective: We tested relations of alternative measures of body size, including height and waist-to-hip ratio (WHR), as well as BMI, with cataract.

Design: This was a prospective follow-up study. We analyzed data from 20271 participants in the Physicians' Health Study who did not have cataract at baseline and for whom there was complete information on weight, height, and other risk factors. For analyses concerning WHR, we excluded 3121 additional men for whom we did not have these measurements, assessed at the ninth year of follow-up. The main outcome measures were incident cataract and cataract surgery.

Results: Among the 17150 men for whom there were complete data, we confirmed an incident cataract in 1727 during an average of 14 y of follow-up. In proportional hazards regression models that adjusted for many known or suspected risk factors, higher BMI [rate ratio (RR) = 1.25 for 27.8 compared with <22, P for trend = 0.03], height (RR = 1.23 for 184 cm compared with 170 cm, P for trend = 0.02), and WHR (RR = 1.31 for top compared with bottom quintile, P for trend = 0.003) were each independently associated with incident cataract.

Conclusions: In addition to BMI, both height and abdominal adiposity are independent risk factors for cataract. These relations are biologically plausible and, if causal, suggest that prevention of obesity and beneficial lifestyle changes resulting in weight loss and reduction of central obesity would lessen the incidence and costs of cataract.

Key Words: Body fat distribution • height • cataract • men • Physicians' Health Study