Cataracts and Subclinical Carotid Atherosclerosis in Older Adults - A Cross-Sectional Study of the HEIJO-KYO Cohort -

Background: 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. Methods and Results: 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 0.07mm (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). Conclusions: Cataracts may be independently associated with subclinical carotid atherosclerosis in the elderly population, indicating a need for further prospective studies.