Evaluating the associations between obesity and age-related cataract: a Mendelian randomization study

2019 ◽  
Vol 110 (4) ◽  
pp. 969-976 ◽  
Author(s):  
Ava Grace Tan ◽  
Annette Kifley ◽  
Victoria M Flood ◽  
Elizabeth G Holliday ◽  
Rodney J Scott ◽  
...  
Keyword(s):  
Instrumental Variable ◽  
Protein Intake ◽  
Mendelian Randomization ◽  
Population Based ◽  
Macronutrient Intake ◽  
Logistic Regression Models ◽  
Blue Mountains ◽  
Age Related ◽  
Blue Mountains Eye Study ◽  
Adjusted Logistic Regression

ABSTRACT Background The obesity–cataract association has been inconsistently reported. The fat mass and obesity–related (FTO) single-nucleotide polymorphism (SNP) rs9939609 is a major SNP associated with obesity and has been used as an instrumental variable for obesity in a Mendelian randomization (MR) approach. An interaction between the FTO SNP and macronutrient intake for obesity was suggested previously. Objective The aim of this study was to assess the associations between obesity and cataract, using FTO SNP rs9939609 as an instrumental variable in an MR approach, and explore interactions of this SNP with macronutrient intake in relation to risk of cataract in a population-based cohort. Methods The Blue Mountains Eye Study (BMES) is a longitudinal population-based study of common eye disease. Of 3654 baseline participants of the BMES (1992–1994), 2334 (75.8% of survivors) and 1952 (76.7% of survivors) were followed 5 and 10 y later. During the 5-y follow-up, 1174 new participants were examined. Cumulative cataract was defined as the presence of cortical, nuclear, or posterior subcapsular (PSC) cataract at any visit, following the Wisconsin Cataract Grading System. Imputed dosage of the FTO SNP rs9939609 was used. Quintiles of macronutrient intake (carbohydrates, protein, fats) were derived from an FFQ. ORs and 95% CIs were estimated using multivariable-adjusted logistic regression models. Results After multivariable adjustment, there were no associations between BMI and any cataract types in MR models using rs9939609 as an instrumental variable. However, an interaction between rs9939609 and protein intake for PSC cataract risk was suggested (P = 0.03). In analyses stratified by quintiles of protein intake, each minor allele of rs9939609 was associated with increased odds of PSC (OR: 2.14; 95% CI: 1.27, 3.60) in the lowest quintile subgroup only. Conclusions Obesity was not causally associated with age-related cataract. However, among persons in the lowest quintile of protein intake, obesity may be associated with PSC cataract.

scholarly journals Wholegrain and legume consumption and the 5-year incidence of age-related cataract in the Blue Mountains Eye Study

2020 ◽  
Vol 124 (3) ◽  
pp. 306-315
Author(s):  
Ava Grace Tan ◽  
Victoria M. Flood ◽  
Annette Kifley ◽  
Joanna Russell ◽  
Robert G. Cumming ◽  
...  
Keyword(s):  
Regression Models ◽  
Population Based ◽  
Eye Diseases ◽  
Australian Population ◽  
Logistic Regression Models ◽  
Blue Mountains ◽  
High Consumption ◽  
Age Related ◽  
Blue Mountains Eye Study ◽  
Adjusted Logistic Regression

AbstractThe present study aims to investigate the effect of wholegrain and legume consumption on the incidence of age-related cataract in an older Australian population-based cohort. The Blue Mountains Eye Study (BMES) is a population-based cohort study of eye diseases among older adults aged 49 years or older (1992–1994, n 3654). Of 2334 participants of the second examination of the BMES (BMES 2, 1997–2000), 1541 (78·3 % of survivors) were examined 5 years later (BMES 3) who had wholegrain and legume consumption estimated from the FFQ at BMES 2. Cataract was assessed using photographs taken during examinations following the Wisconsin cataract grading system. Multivariable-adjusted logistic regression models were used to assess associations with the 5-year incidence of cataract from BMES 2 (baseline) to BMES 3. The 5-year incidence of cortical, nuclear and posterior subcapsular (PSC) cataract was 18·2, 16·5 and 5·9 %, respectively. After adjustment for age, sex and other factors, total wholegrain consumption at baseline was not associated with incidence of any type of cataract. High consumption of legumes showed a protective association for incident PSC cataract (5th quintile: adjusted OR 0·37; 95 % CI 0·15, 0·92). There was no significant trend of this association across quintiles (P = 0·08). In this older Australian population, we found no associations between wholegrain intake at baseline and the 5-year incidence of three cataract types. However, intake of legumes in the highest quintile, compared with the lowest quintile, may protect against PSC formation, a finding needing replication in other studies.

Abstract 12069: Long-Term Trends in the Incidence and Outcome of Refractory and Non-Refractory Ventricular Fibrillation Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Ziad Nehme ◽  
Emily Andrew ◽  
Jocasta Ball ◽  
Karen L Smith
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Discharge ◽  
Temporal Trends ◽  
Developed Countries ◽  
Population Based ◽  
Logistic Regression Models ◽  
Shockable Rhythm ◽  
Adjusted Logistic Regression ◽  
Population Based Registry

Introduction: Although many developed countries are reporting temporal improvements in out-of-hospital cardiac arrest (OHCA) outcomes from initial shockable rhythms, trends in the incidence and outcome of refractory ventricular fibrillation are not well understood. Methods: Between 2010 and 2019, we performed a retrospective observational study of OHCA from a population-based registry in Victoria, Australia. We included all adult, non-traumatic OHCA with an initial shockable rhythm. Temporal trends in incidence and survival to hospital discharge were compared across non-refractory and refractory OHCA, defined as cases receiving 3 or more consecutive shocks for a persistent shockable rhythm. Risk-adjusted logistic regression models were used to describe the year-on-year change in the likelihood of refractory OHCA and survival to hospital discharge. Results: Of the 7,267 initial shockable OHCA with an attempted resuscitation, 4168 (57.4%) and 3,099 (42.6%) were non-refractory and refractory OHCA, respectively. The proportion of cases with refractory OHCA declined over the study period from 48.4% in 2010 to 40.2% in 2019 (p trend <0.001). Unadjusted survival to hospital discharge was higher in non-refractory OHCA (46.3% vs. 25.8%, p<0.001), although both populations experienced increases in survival over time (p trend <0.05 for both). After adjustment for arrest confounders, the likelihood of refractory VF decreased by 4.4% every year (adjusted odds ratio [AOR]: 0.96, 95% CI: 0.94, 0.97; p<0.001). Factors reducing the likelihood of refractory OHCA were female sex, bystander CPR, arrest witnessed by emergency medical services, and public location. In the survival model, refractory OHCA was independently associated with a reduction in survival to hospital discharge (AOR 0.50, 95% CI: 0.45, 0.56; p<0.001). Temporal improvements in survival were observed year-on-year (AOR 1.03, 95% CI: 1.02, 1.05; p<0.001) and this did not differ between non-refractory and refractory OHCA (group interaction, p = 0.51). Conclusions: The incidence of refractory OHCA is declining in our region and survival outcomes are improving. Further research identifying factors contributing to the decline in refractory OHCA may help to improve outcomes further.

scholarly journals The Combination of Healthy Diet and Healthy Body Weight Is Associated with Lower Risk of Nuclear Cataract in the Blue Mountains Eye Study

2019 ◽  
Vol 149 (9) ◽  
pp. 1617-1622 ◽  
Author(s):  
Ava Grace Tan ◽  
Annette Kifley ◽  
Victoria M Flood ◽  
Joanna Russell ◽  
George Burlutsky ◽  
...  
Keyword(s):  
Visual Impairment ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Study Cohort ◽  
Nuclear Cataract ◽  
Blue Mountains ◽  
Age Related ◽  
Total Diet ◽  
Blue Mountains Eye Study ◽  
Diet Score

ABSTRACT Background Greater adherence to dietary guidelines has previously been found to be associated with decreased risk of visual impairment. However, whether or not this association extends to age-related cataract, 1 of the leading causes of visual impairment, is unknown. Objectives The aim of this study was to assess the association between adherence to dietary guidelines, using total diet score, and incidence of age-related cataract. Methods Of 3654 baseline participants of the population-based Blue Mountains Eye Study cohort (1992–1994), 2334 (75.8% survivors) and 1952 (76.7% survivors) were examined after 5 and 10 y, respectively. Cataract was assessed from lens photographs using the Wisconsin Cataract Grading System. Baseline total diet score was calculated from FFQ data following a modified version of the Healthy Eating Index for Australians. OR with 95% CI were estimated using discrete logistic regression analyses, adjusting for age, sex, and other confounders. To test interaction, a cross-product term of 2 factors was included in regression models. Results Of 2173 participants (84.7% of those returned for 1 or both follow-ups) with total diet score estimated, 57% were women, mean baseline age was 63.9 ± 8.4y, and mean baseline BMI was 26.3 ± 4.3 kg/m2. After multivariable adjustment, baseline total diet score was not associated with incidence of any cataract. A multiplicative interaction was observed between total diet score and BMI for incident nuclear cataract (P-interaction = 0.04): increasing baseline total diet score was associated with decreased risk of nuclear cataract among participants with BMI <25 (per unit increased total diet score, OR: 0.90; 95% CI: 0.81, 0.99; P = 0.02), but not among participants with BMI ≥25 (OR: 1.00; 95% CI: 0.92, 1.10; P = 0.95). Conclusions Adherence to dietary guidelines had no appreciable influence on cataract development overall in this older Australian population. However, adherence to dietary guidelines combined with healthy BMI is associated with decreased risk of nuclear cataract, an aging marker.

scholarly journals Antioxidant nutrient intake and the long-term incidence of age-related cataract: the Blue Mountains Eye Study

2008 ◽  
Vol 87 (6) ◽  
pp. 1899-1905 ◽  
Author(s):  
Ava Grace Tan ◽  
Paul Mitchell ◽  
Victoria M Flood ◽  
George Burlutsky ◽  
Elena Rochtchina ◽  
...  
Keyword(s):  
Nutrient Intake ◽  
Blue Mountains ◽  
Age Related ◽  
Blue Mountains Eye Study

scholarly journals The association of diabetes and BMI among Melanesian and Indian Fijians aged ≥ 40 years

2011 ◽  
Vol 105 (10) ◽  
pp. 1539-1545 ◽  
Author(s):  
Garry Brian ◽  
Jacqueline Ramke ◽  
Andrew Page ◽  
Louise Maher ◽  
John Szetu ◽  
...  
Keyword(s):  
Regression Models ◽  
Medical Practitioner ◽  
Population Based ◽  
Common Environment ◽  
Logistic Regression Models ◽  
Previous Diagnosis ◽  
Males And Females ◽  
Adjusted Logistic Regression ◽  
Hb Concentration ◽  
Population Based Survey

The present study examines the association of diabetes with BMI (kg/m2) in Asian-Indian and Melanesian Fijian populations sharing a common environment. A population-based survey was used to investigate the risk of diabetes (defined by glycosylated Hb concentration ≥ 6·5 % among participants who denied previous diagnosis of the disease by a medical practitioner) by sex, ethnicity and strata of BMI in a series of age-adjusted logistic regression models. Ethnicity and BMI interactions were compared using WHO and empirically derived BMI cut-off points. Indians had a greater risk (BMI and age adjusted) of undetected diabetes than Melanesians in both males (OR 2·99, 95 % CI 1·73, 5·17; P < 0·001) and females (OR 2·26, 95 % CI 1·56, 3·28; P < 0·001). BMI ≥ 25 to < 30 and ≥ 30 kg/m2 conferred a higher risk of diabetes compared with a BMI ≥ 18·5 to < 25 kg/m2. Risk was higher for males with a BMI ≥ 25 to < 30 kg/m2 (OR 2·35, 95 % CI 1·24, 4·46; P = 0·007) and BMI ≥ 30 kg/m2 (OR 6·08, 95 % CI 3·06, 12·07; P < 0·001) than for females with the same BMI (OR 1·85, 95 % CI 1·11, 3·08; P = 0·027 and OR 2·10, 95 % CI 1·28, 3·44; P = 0·002, respectively). However, the threshold that appeared to differentiate higher risk varied by ethnicity and sex. For Melanesians, BMI thresholds suggested were 25 kg/m2 for males and 32 kg/m2 for females. For Indo-Fijians, these were 24 and 22 kg/m2 for males and females, respectively. Disaggregating by ethnicity and sex, and applying specific evidence-based thresholds, may render BMI a more discriminating tool for assessing the risk of developing diabetes among Fiji adults.

Dietary Macronutrient Intake and Five-Year Incident Cataract: The Blue Mountains Eye Study

2007 ◽  
Vol 143 (6) ◽  
pp. 932-939.e1 ◽  
Author(s):  
Bradley S. Townend ◽  
Marcia E. Townend ◽  
Victoria Flood ◽  
George Burlutsky ◽  
Elena Rochtchina ◽  
...  
Keyword(s):  
Macronutrient Intake ◽  
Blue Mountains ◽  
Blue Mountains Eye Study
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