Abstract
Background
Cataract is a leading cause of blindness worldwide. However, little is known about sex differences in cataracts. Our study aimed to explore potential sex differences in the relationships between key social, lifestyle, and physical health risk factors and the incidence of cataracts.
Methods
A total of 117,972 participants from the UK Biobank were included in this prospective cohort study. Cox proportional hazard models were used to calculate hazard ratios (HRs) and female-to-male ratios of HRs (RHRs) with 95% confidence intervals (CIs) for cataract risk factors. Poisson regression was used to assess the incidence of cataracts (per 10,000 person-years).
Results
A total of 117,972 individuals without preexisting eye diseases were enroled in the analysis. 4172 subjects (54.8% female) were diagnosed with cataracts during follow-up. The crude incidence rates per 10,000 person-years were 35.06 for females and 29.15 for males. The incidence of cataracts increased in both males and females with factors such as Asian or Black ethnicity, smoking status, obesity, diabetes, and myopia. However, males who consumed alcohol or were unemployed suffered a greater risk of cataracts compared to their female counterparts, while high socioeconomic status, elevated blood pressure and metabolic syndrome were associated with a greater risk of cataracts in females than in males.
Conclusion
This study provides a comprehensive overview of sex differences in the associations between cataracts and various risk factors. Our findings highlight that socioeconomic and lifestyle risk factors are more strongly linked to cataract risk in males, whereas females with systemic diseases face a greater risk of developing cataract.
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Data availability
All data from the UK Biobank dataset are available at https://biobank.ndph.ox.ac.uk/ by application. The variables used here are detailed in Supplementary Table 1.
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Acknowledgements
The study has been conducted using the UK Biobank Resource under Application #86091. We thank the participants of UK Biobank.
Funding
The present work was funded by the National Natural Science Foundation of China (82171075, 82301260, 82271125, 82301205), the Medical Scientific Research Foundation of Guangdong Province, China (A2021378), the Science and Technology Program of Guangzhou, China (20220610092, 202103000045), the Outstanding Young Talent Trainee Program of Guangdong Provincial People's Hospital (KJ012019087), the launch fund of Guangdong Provincial People's Hospital for NSFC (8217040546, 8220040257, 8217040449, 8227040339), Personalized Medical Incubator Project, The fund for Precison Medicine Research and Industry Development in SIMQ (2023-31), Guangdong Basic and Applied Basic Research Foundation (2023B1515120028). The funders had no role in the study design, data collection, data analysis, data interpretation, or report writing.
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Study concept and design: Yuling Xu, Xiayin Zhang, Honghua Yu; Acquisition, analysis, or interpretation: Yuling Xu, Anyi Liang, Xiayin Zhang, Wei Sun; Drafting of the manuscript: Yuling Xu, Qinyi Li, Ting Su, Zijing Du; Critical revision of the manuscript for important intellectual content: Anyi Liang, Xianqi Zheng, Xiayin Zhang, Ziyi Huang, Qiaowei Wu. Statistical analysis: Yuling Xu, Anyi Liang; Obtained funding: Honghua Yu, Xiayin Zhang, Anyi Liang. Administrative, technical, or material support: Ying Fang, Wei Sun, Yijun Hu; Study supervision: Honghua Yu, Xiayin Zhang, Wei Sun.
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UK Biobank was approved by the North West Multi-Centre Research Ethics Committee (Ref: 11/NW/0382, https://www.ukbiobank.ac.uk/learn-more-about-uk-biobank/about-us/ethics).
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Xu, Y., Liang, A., Zheng, X. et al. Sex-specific social, lifestyle, and physical health risk factors in cataracts development. Eye 38, 2939–2946 (2024). https://doi.org/10.1038/s41433-024-03193-z
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DOI: https://doi.org/10.1038/s41433-024-03193-z
