SEARCHCOHORTophthalmology, cataract surgery

cohort·ophthalmology, cataract surgery, epidemiology, gastroenterology, public health·PMC10831806

Associations of severe liver diseases with cataract using data from UK Biobank: a prospective cohort study

eClinicalMedicine · 8 authors, 8 centres

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TL;DR

This large prospective cohort study found that severe liver diseases, including NAFLD, alcoholic liver disease, liver fibrosis/cirrhosis, and recently diagnosed viral hepatitis, were associated with an increased risk of developing cataracts.

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The study analyzed data from 326,558 UK Biobank participants over a median follow-up of 13.3 years. Using Cox proportional hazards models, it found that severe liver diseases defined by hospital admission, including NAFLD (HR 1.47), ALD (HR 1.57), and liver fibrosis and cirrhosis (HR 1.58), were associated with a higher risk of incident cataract. Viral hepatitis showed a significant association only when recently diagnosed within 5 years (HR 1.55). These associations were independent of other risk factors. The study is limited by potential selection bias from UK Biobank's design, missing data for some covariates, and the observational nature preventing causal conclusions.

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cohort

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ophthalmology

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ORIGINAL PAPER

PMC10831806

Associations of severe liver diseases with cataract using data from UK Biobank: a prospective cohort study

eClinicalMedicine

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ABSTRACT

Summary Background Liver disease is linked to series of extrahepatic multisystem manifestations. However, little is known about the associations between liver and eye diseases, especially cataract, the global leading cause of blindness. We aimed to investigate whether severe liver diseases, including non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), viral hepatitis, and liver fibrosis and cirrhosis, were associated with an increased risk of the cataract. Methods A total of 326,558 participants without cataract at baseline enrolled in the UK Biobank between 2006 and 2010 were included in this prospective study. The exposures of interest were severe liver diseases (defined as hospital admission), including NAFLD, ALD, viral hepatitis and liver fibrosis and cirrhosis. The outcome was incident cataract. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Each liver disease was first treated as a binary time-varying variable to investigate its association with cataract, and then was treated as a ternary time-varying variable to examine the recent (liver disease within 0–5 years) vs. long-term (liver disease > 5 years) state associations with the risk of cataract. Findings After a median follow-up of 13.3 years (interquartile range, 12.5–14.0 years), 37,064 individuals were documented as developing cataract. Higher risk of cataract was found in those with severe NAFLD (HR, 1.47; 95% CI, 1.33–1.61), ALD (HR, 1.57; 95% CI, 1.28–1.94) and liver fibrosis and cirrhosis (HR, 1.58; 95% CI, 1.35–1.85), but not in individuals with viral hepatitis when exposure was treated as a binary time-varying variable (P = 0.13). When treating exposure as a ternary time-varying variable, an association between recently diagnosed viral hepatitis and cataract was also observed (HR, 1.55; 95% CI, 1.07–2.23). Results from the combined model suggested they were independent risk factors for incident cataract. No substantial changes were found in further sensitivity analyses. Interpretation Severe liver diseases, including NAFLD, ALD, liver fibrosis and cirrhosis and recently diagnosed viral hepatitis, were associated with cataract. The revelation of liver-eye connection suggests the importance of ophthalmic care in the management of liver disease, and the intervention precedence of patients with liver disease in the early screening and diagnosis of cataract. Funding 10.13039/501100001809 National Natural Science Foundation of China , Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission , Clinical Research Plan of 10.13039/501100014137 Shanghai Shenkang Hospital Development Center , Shanghai Municipal Key Clinical Specialty Program , the 10.13039/501100021171 Guangdong Basic and Applied Basic Research Foundation and Shenzhen Science and Technology Program .

CITATION EXPORT

Chao Chen, Ling Wei, Wenwen He et al.. Associations of severe liver diseases with cataract using data from UK Biobank: a prospective cohort study. eClinicalMedicine. (2024). https://doi.org/10.1016/j.eclinm.2024.102424

AUTHORS

8 · 8 CENTRES

Chao Chen, Ling Wei, Wenwen He, Ye Zhang, Jia Xiao, Yi Lu, Fei Wang, Xiangjia Zhu

aEye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
bNHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
cKey Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
dShanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
eChangsha Aier Eye Hospital, Changsha, Hunan Province 410015, China
fAier Eye Institute, Changsha, Hunan Province 410015, China
gShandong Provincial Key Laboratory for Clinical Research of Liver Diseases, Qingdao Hospital, University of Health and Rehabilitation Sciences, Qingdao 266001, China
hDivision of Gastroenterology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China