Cataracts are Associated with the Coexistence of Moderate to Severe Obstructive Sleep Apnea and Diabetes Mellitus

Abstract

Background and Objective The individual presence of diabetes mellitus (DM) or obstructive sleep apnea (OSA) is significantly associated with cataract formation, but few studies have examined the association of cataracts with comorbid DM and OSA. Our aim in this study was to confirm the relationship between cataracts and the individual presence of DM or OSA in a large population-based cohort study and evaluate the association between cataracts and the coexistence of OSA and DM. Methods We included 699 individuals who were enrolled in the Korean Genome and Epidemiology Study and who underwent both nocturnal polysomnography and cataract diagnosis in the study. We assessed the presence and severity of OSA by means of unattended home sleep monitoring. DM was diagnosed based on the fasting blood-glucose level or by the use of antihyperglycemic medications. Cataracts were diagnosed according to the Lens Opacities Classification System III. Results The prevalence of cataracts tended to increase as OSA worsened. Diabetes patients had a higher prevalence of cataracts than did normal subjects. In multivariate analysis, there was no significant association of cataracts with DM or OSA alone. In the joint analysis of DM and OSA, however, the odds for cataracts were significantly higher in the DM patients with moderate to severe OSA than in the DM patients without OSA, indicating a significant synergy of moderate to severe OSA and DM on cataracts. Conclusions The concurrent presence of DM and moderate to severe OSA was associated with cataracts. Thus, OSA should be considered in the prevention or treatment of diabetic cataracts.

Keywords

• obstructive sleep apnea
• cataracts
• diabetes mellitus
• interaction