Background
Methods
Study design and population
Ophthalmologic examinations
Outcome variable
Independent variables
Statistical methods
Results
Baseline characteristics of the study population
n | % | |
---|---|---|
1. Socio-demographic factors
| ||
Age (years) | ||
40–49 | 3353 | 28.9 |
50–59 | 3019 | 26.1 |
60–69 | 2813 | 24.3 |
70–80 | 1959 | 16.9 |
80+ | 447 | 3.9 |
Sex | ||
Men | 5000 | 43.1 |
Women | 6591 | 56.9 |
Monthly household income | ||
Lowest quintile | 3108 | 26.8 |
2nd to 4th quintile | 5946 | 51.3 |
Highest quintile | 2355 | 20.3 |
Education | ||
Elementary school | 4644 | 40.1 |
Middle school | 1779 | 15.4 |
High school | 3111 | 26.8 |
University or higher | 1929 | 16.6 |
Residential area | ||
Urban | 8124 | 70.1 |
Rural | 3467 | 29.9 |
Occupation | ||
Administrator, management, and professional | 883 | 7.6 |
Business and financial operations | 548 | 4.7 |
Sales and related | 1416 | 12.2 |
Farming, fishing, and forestry | 1539 | 13.3 |
Installation, maintenance, and repair | 1089 | 9.4 |
Laborer | 1208 | 10.4 |
Unemployed | 4761 | 41.1 |
2. Health examination variable
| ||
Obesity | ||
Underweight | 7223 | 62.3 |
Normal | 3980 | 34.3 |
Obesity | 357 | 3.1 |
Hypercholesterolemia | ||
No | 8978 | 77.5 |
Yes | 1695 | 14.6 |
Hypo-HDL-cholesterolemia | ||
No | 7613 | 65.7 |
Yes | 3122 | 26.9 |
Hypertriglycemia | ||
No | 7257 | 62.6 |
Yes | 1547 | 13.4 |
Anemia | ||
No | 9778 | 84.4 |
Yes | 1150 | 9.9 |
Metabolic syndrome | ||
No | 6782 | 58.5 |
Yes | 4809 | 41.5 |
3. Comorbidities
| ||
Hypertension | ||
No | 8033 | 69.3 |
Yes | 3472 | 30.0 |
Diabetic mellitus | ||
No | 10237 | 88.3 |
Yes | 1267 | 10.9 |
Osteoarthritis | ||
No | 9596 | 82.8 |
Yes | 1907 | 16.5 |
Rheumatoid arthritis | ||
No | 11161 | 96.3 |
Yes | 342 | 3.0 |
Atopic dermatitis | ||
No
| 11339 | 97.8 |
Yes | 163 | 1.4 |
Asthma | ||
No | 11083 | 95.6 |
Yes | 421 | 3.6 |
4. Health behavioral risk factors
| ||
Lifetime smoker | ||
No | 6797 | 58.6 |
Yes | 4704 | 40.6 |
Binge alcohol user | ||
No | 8375 | 72.3 |
Yes | 3140 | 27.1 |
Physical activity of moderate intensity | ||
never | 11078 | 95.6 |
more than once in a week | 394 | 3.4 |
Coffee consumption | ||
Never | 1393 | 12.0 |
1–6 cups per week | 2236 | 19.3 |
≥7 cups per week | 6476 | 55.9 |
Stress | ||
Least stressful | 2249 | 19.4 |
Moderately stressful | 8671 | 74.8 |
Extremely stressful | 557 | 4.8 |
Sun exposure | ||
<5 hr/day | 8182 | 70.6 |
≥5 hr/day | 3286 | 28.4 |
Cataract prevalence
% | 95% CI | |
---|---|---|
All
| ||
40 ~ 49 | 10.4 | (8.4 −12.4 ) |
50 ~ 59 | 33.1 | (29.6 −36.6 ) |
60 ~ 69 | 69.4 | (66.0 −72.8 ) |
70 ~ 80 | 91.2 | (89.2 −93.3 ) |
80~ | 97.9 | (96.4 −99.5 ) |
≥40* | 40.1 | (37.9 −42.3 ) |
≥50 | 58.1 | (55.5 −60.8 ) |
≥60 | 80.2 | (77.9 −82.4 ) |
≥70 | 92.7 | (91.0 −94.3 ) |
≥80 | 97.9 | (96.4 −99.5 ) |
Men
| ||
40 ~ 49 | 10.7 | (8.5 −13.0 ) |
50 ~ 59 | 34.6 | (30.4 −38.8 ) |
60 ~ 69 | 68.4 | (64.2 −72.7 ) |
70 ~ 80 | 89.6 | (86.6 −92.5 ) |
80~ | 96.7 | (93.7 −99.7 ) |
Women
| ||
40 ~ 49 | 10.0 | (7.7 −12.3 ) |
50 ~ 59 | 31.6 | (27.8 −35.4 ) |
60 ~ 69 | 70.3 | (66.5 −74.0 ) |
70 ~ 80 | 92.3 | (90.0 −94.6 ) |
80~ | 98.5 | (97.0 −100.0 ) |
Factors associated with cataracts
Univariate OR | 95% CI | p | |
---|---|---|---|
1. Socio-demographic factors
| |||
Age (years) | |||
40–49 | 1.0 (ref) | ||
50–59 |
4.3
|
3.8–5.0
|
<0.01
|
60–69 |
21.0
|
18.3–24.1
|
<0.01
|
70–80 |
92.6
|
76.4–112.4
|
<0.01
|
80+ |
344.5
|
187.4–633.1
|
<0.01
|
Sex | |||
Men | 1.0 (ref) | ||
Women |
1.0
|
1.0–1.1
|
0.35
|
Monthly household income | |||
Lowest quintile | 1.0 (ref) | ||
2nd to 4th quintile |
0.2
|
0.2–0.3
|
<0.01
|
Highest quintile |
0.1
|
0.1–0.1
|
<0.01
|
Education | |||
Elementary school | 1.0 (ref) | ||
Middle school |
0.3
|
0.3–0.4
|
<0.01
|
High school |
0.2
|
0.2–0.2
|
<0.01
|
University or higher |
0.1
|
0.1–0.1
|
<0.01
|
Residential area | |||
Urban | 1.0 (ref) | ||
Rural |
1.8
|
1.6–1.9
|
<0.01
|
Occupation | |||
Administrator, management, and professional | 1.0 (ref) | ||
Business and financial operations |
0.9
|
0.7–1.2
|
0.49
|
Sales and related |
1.6
|
1.3–1.9
|
<0.01
|
Farming, fishing, and forestry |
6.8
|
5.6–8.3
|
<0.01
|
Installation, maintenance, and repair |
1.6
|
1.3–2.0
|
<0.01
|
Laborer |
3.6
|
2.9–4.4
|
<0.01
|
Unemployed |
6.5
|
5.5–7.8
|
<0.01
|
2. Health examination variable
| |||
Obesity | |||
Underweight | 1.0 (ref) | ||
Normal |
1.0
|
0.9–1.1
|
0.80
|
Obesity |
2.1
|
1.7–2.7
|
<0.01
|
Hypercholesterolemia | |||
No | 1.0 (ref) | ||
Yes |
1.5
|
1.3–1.6
|
<0.01
|
Hypo-HDL-cholesterolemia | |||
No | 1.0 (ref) | ||
Yes |
1.4
|
1.2–1.5
|
<0.01
|
Hypertriglycemia | |||
No | 1.0 (ref) | ||
Yes |
1.1
|
1.0–1.2
|
0.13
|
Anemia | |||
No | 1.0 (ref) | ||
Yes |
1.3
|
1.2–1.5
|
<0.01
|
Metabolic syndrome | |||
No | 1.0 (ref) | ||
Yes |
2.1
|
1.9–2.2
|
<0.01
|
3. Comorbidities
| |||
Hypertension | |||
No | 1.0 (ref) | ||
Yes |
3.1
|
2.8–3.3
|
<0.01
|
Diabetic mellitus | |||
No | 1.0 (ref) | ||
Yes |
3.1
|
2.7–3.5
|
<0.01
|
Osteoarthritis | |||
No | 1.0 (ref) | ||
Yes |
2.8
|
2.5–3.1
|
<0.01
|
Rheumatoid arthritis | |||
No | 1.0 (ref) | ||
Yes |
2.1
|
1.7–2.6
|
<0.01
|
Atopic dermatitis | |||
No | 1.0 (ref) | ||
Yes |
0.7
|
0.5–1.0
|
0.06
|
Asthma | |||
No | 1.0 (ref) | ||
Yes |
1.9
|
1.6–2.3
|
<0.01
|
4. Health behavioral risk factors
| |||
Lifetime smoker | |||
No | 1.0 (ref) | ||
Yes |
1.0
|
0.9–1.1
|
0.82
|
Binge alcohol user | |||
No | 1.0 (ref) | ||
Yes |
0.5
|
0.4–0.5
|
<0.01
|
Physical activity of moderate intensity | |||
Never | 1.0 (ref) | ||
>5 times per week |
1.1
|
0.9–1.3
|
0.51
|
Coffee consumption | |||
Never | 1.0 (ref) | ||
1–6 cups per week |
0.7
|
0.6–0.8
|
<0.01
|
≥7 cups per week |
0.5
|
0.4–0.5
|
<0.01
|
Stress | |||
Least stress | 1.0 (ref) | ||
Moderately stressful |
0.4
|
0.4–0.5
|
<0.01
|
Extreme stress |
0.6
|
0.5–0.7
|
<0.01
|
Sun exposure | |||
<5 hr/day | 1.0 (ref) | ||
≥5 hr/day |
1.7
|
1.6–1.9
|
<0.01
|
Multivariate OR | 95% CI | p | |
---|---|---|---|
1. Socio-demographic factors
| |||
Age (years) | |||
40–49 |
1.0 (ref)
| ||
50–59 |
3.7
|
3.2–4.3
|
<0.01
|
60–69 |
14.9
|
12.7–17.4
|
<0.01
|
70–80 |
57.3
|
46.0–71.3
|
<0.01
|
80+ |
192.7
|
103.6–358.4
|
<0.01
|
Sex | |||
Men |
1.0 (ref)
| ||
Women |
0.9
|
0.8–1.0
|
0.02
|
Monthly household income | |||
Lowest quintile |
1.0 (ref)
| ||
2nd to 4th quintile |
0.9
|
0.7–1.0
|
0.04
|
Highest quintile |
0.7
|
0.6–0.9
|
<0.01
|
Education | |||
Elementary school |
1.0 (ref)
| ||
Middle school |
0.8
|
0.7–0.9
|
<0.01
|
High school |
0.7
|
0.6–0.8
|
<0.01
|
University or higher |
0.6
|
0.5–0.7
|
<0.01
|
Residential area | |||
Urban | 1.0 (ref) | ||
Rural | 1.0 | 0.9–1.2 | 0.57 |
Occupation | |||
Administrator, management, and professional | 1.0 (ref) | ||
Business and financial operations | 1.0 | 0.8–1.4 | 0.78 |
Sales and related | 1.0 | 0.8–1.3 | 0.79 |
Farming, fishing, and forestry | 1.1 | 0.8–1.4 | 0.49 |
Installation, maintenance, and repair | 1.0 | 0.7–1.3 | 0.83 |
Laborer | 1.1 | 0.8–1.4 | 0.54 |
Unemployed | 1.2 | 1.0–1.5 | 0.09 |
2. Health examination variable
| |||
Obesity | |||
Underweight | 1.0 (ref) | ||
Normal | 1.0 | 0.8–1.1 | 0.44 |
Obesity | 1.4 | 0.9–1.9 | 0.10 |
Hypercholesterolemia | |||
No | 1.0 (ref) | ||
Yes |
1.2
|
1.0–1.4
|
0.03
|
Hypo-HDL-cholesterolemia | |||
No | 1.0 (ref) | ||
Yes | 1.0 | 0.8–1.1 | 0.64 |
Hypertriglycemia | |||
No | 1.0 (ref) | ||
Yes | 0.9 | 0.7–1.0 | 0.10 |
Anemia | |||
No | 1.0 (ref) | ||
Yes |
1.2
|
1.0–1.5
|
0.05
|
Metabolic syndrome | |||
No | 1.0 (ref) | ||
Yes |
1.2
|
1.1–1.4
|
<0.01
|
3. Comorbidities
| |||
Hypertension | |||
No | 1.0 (ref) | ||
Yes |
1.2
|
1.0–1.3
|
<0.01
|
Diabetic mellitus | |||
No | 1.0 (ref) | ||
Yes |
1.7
|
1.4–2.0
|
<0.01
|
Osteoarthritis | |||
No | 1.0 (ref) | ||
Yes | 1.1 | 0.9–1.2 | 0.31 |
Rheumatoid arthritis | |||
No | 1.0 (ref) | ||
Yes | 1.1 | 0.8–1.4 | 0.55 |
Atopic dermatitis | |||
No | 1.0 (ref) | ||
Yes | 0.9 | 0.6–1.3 | 0.45 |
Asthma | |||
No | 1.0 (ref) | ||
Yes | 1.0 | 0.8–1.3 | 0.92 |
4. Health behavioral risk factors
| |||
Lifetime smoker | |||
No | 1.0 (ref) | ||
Yes | 1.0 | 0.9–1.2 | 0.59 |
Binge alcohol user | |||
No | 1.0 (ref) | ||
Yes | 0.9 | 0.8–1.0 | 0.14 |
Physical activity of moderate intensity | |||
Never | 1.0 (ref) | ||
>5 times per week | 1.0 | 0.8–1.3 | 0.93 |
Coffee consumption | |||
Never | 1.0 (ref) | ||
1–6 cups per week | 0.9 | 0.8–1.1 | 0.50 |
≥7 cups per week | 0.9 | 0.7–1.0 | 0.09 |
Stress | |||
Least stress | 1.0 (ref) | ||
Moderate stress | 0.9 | 0.8–1.0 | 0.07 |
Extreme stress | 1.1 | 0.8–1.4 | 0.59 |
Sun exposure | |||
<5 hr/day | 1.0 (ref) | ||
≥5 hr/day | 1.1 | 1.0–1.2 | 0.09 |
Univariate OR | Multivariate OR | 95% CI | p | |
---|---|---|---|---|
1. Socio-demographic factors
| ||||
Age (years) | ||||
40–49 | 1.0 (ref) |
1.0 (ref)
| ||
50–59 | 4.3 |
3.5
|
3.0–4.1
|
<0.01
|
60–69 | 21.0 |
14.3
|
12.1–16.8
|
<0.01
|
70–80 | 92.6 |
53.1
|
42.5–66.4
|
<0.01
|
80+ | 344.5 |
194.1
|
94.5–398.6
|
<0.01
|
Sex | ||||
Men | 1.0 (ref) | 1.0 (ref) | ||
Women | 1.0 | 0.9 | 0.8–1.0 | 0.14 |
Monthly household income | ||||
Lowest quintile | 1.0 (ref) |
1.0 (ref)
| ||
2nd to 4th quintile | 0.2 |
0.9
|
0.7–1.0
|
0.05
|
Highest quintile | 0.1 |
0.7
|
0.6–0.9
|
<0.01
|
Education | ||||
Elementary school | 1.0 (ref) |
1.0 (ref)
| ||
Middle school | 0.3 |
0.8
|
0.7–0.9
|
<0.01
|
High school | 0.2 |
0.7
|
0.6–0.8
|
<0.01
|
University or higher | 0.1 |
0.6
|
0.5–0.7
|
<0.01
|
2. Health examination variable
| ||||
Hypercholesterolemia | ||||
No | 1.0 (ref) |
1.0 (ref)
| ||
Yes | 1.5 |
1.2
|
1.0–1.3
|
0.02
|
Anemia | ||||
No | 1.0 (ref) | 1.0 (ref) | ||
Yes | 1.3 | 1.1 | 0.9–1.3 | 0.18 |
Metabolic syndrome | ||||
No | 1.0 (ref) | 1.0 (ref) | ||
Yes | 2.1 | 1.1 | 0.9–1.2 | 0.32 |
3. Comorbidities
| ||||
Hypertension | ||||
No | 1.0 (ref) |
1.0 (ref)
| ||
Yes | 3.1 |
1.1
|
1.0–1.3
|
0.02
|
Diabetic mellitus | ||||
No | 1.0 (ref) |
1.0 (ref)
| ||
Yes | 3.1 |
1.6
|
1.3–1.9
|
<0.01
|
Pure Cortical type n = 7008 | Pure Nuclear type | Pure PSCO type | Mixed type | |||||
---|---|---|---|---|---|---|---|---|
Multivariate OR | p value | Multivariate OR | p value | Multivariate OR | p value | Multivariate OR | p value | |
1. Socio-demographic factors
| ||||||||
Age (years) | ||||||||
40–49 | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
50–59 |
2.8
|
<0.01
|
4.1
|
<0.01
|
3.2
|
0.07
|
4.1
|
<0.01
|
60–69 |
9.0
|
<0.01
|
15.7
|
<0.01
|
6.9
|
<0.01
|
22.6
|
<0.01
|
70–80 |
26.4
|
<0.01
|
44.8
|
<0.01
|
24.1
|
<0.01
|
104.3
|
<0.01
|
80+ |
59.6
|
<0.01
|
138.2
|
<0.01
|
135.9
|
<0.01
|
414.0
|
<0.01
|
Sex | ||||||||
Men | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
Women | 0.9 | 0.07 | 1.0 | 0.87 | 1.0 | 0.92 | 1.1 | 0.50 |
Monthly household income | ||||||||
Lowest quintile | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
2nd to 4th quintile |
0.7
|
<0.01
| 1.0 | 0.97 | 0.5 | 0.07 |
0.8
|
0.02
|
Highest quintile |
0.7
|
<0.01
| 1.0 | 0.78 | 0.4 | 0.12 |
0.6
|
<0.01
|
Education | ||||||||
Elementary school | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
Middle school | 0.8 | 0.11 |
0.8
|
0.02
| 0.7 | 0.52 | 0.8 | 0.11 |
High school |
0.6
|
<0.01
|
0.8
|
0.02
| 1.0 | 0.93 |
0.6
|
<0.01
|
Univ. or higher |
0.5
|
<0.01
|
0.6
|
<0.01
| 0.9 | 0.93 | 0.9 | 0.56 |
2. Health examination variable
| ||||||||
Hypercholesterolemia | ||||||||
No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
Yes |
1.3
|
0.02
| 1.0 | 0.61 | 1.6 | 0.28 | 1.1 | 0.26 |
Anemia | ||||||||
No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
Yes | 0.9 | 0.70 | 1.1 | 0.29 | 1.0 | 0.96 | 1.3 | 0.12 |
Metabolic syndrome | ||||||||
No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
Yes | 0.9 | 0.23 |
1.2
|
0.02
| 0.6 | 0.17 | 1.2 | 0.13 |
3. Comorbidities
| ||||||||
Hypertension | ||||||||
No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
Yes | 1.2 | 0.14 | 1.0 | 0.88 | 1.1 | 0.86 | 1.2 | 0.16 |
Diabetic mellitus | ||||||||
No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | ||||
Yes |
1.3
|
0.05
|
1.4
|
<0.01
|
2.7
|
0.04
|
1.4
|
0.02
|
Diabetes Mellitus (DM) | RR (95% CI); p for with versus without DM within strata of hypertension | ||||
---|---|---|---|---|---|
No | Yes | ||||
Hypertension | % | RR (95% CI) | % | RR (95% CI) | |
No | 2852/7502 (38%) | 1.0 | 345/531 (65%) | 1.7 (1.4–2.2) p < 0.01 | 1.7 (1.4–2.2) p < 0.01 |
Yes | 1757/2735 (64%) | 1.2 (1.1–1.3) p < 0.01 | 565/736 (77%) | 2.0 (1.6–2.5) p < 0.01 | 1.1 (0.9–1.5) p = 0.37 |