Statins are widely used to decrease serum cholesterol for cardiovascular disease prevention. Statins have also been shown to have antioxidant activity. Oxidative stress (a condition in which antioxidant levels are lower than normal) has been thought to be a risk factor for age-related cataract, particularly nuclear cataract (the most common type of age-related cataract, which occurs in the center of the lens). Some evidence has suggested an association between nutritional intake of antioxidants and age-related cataract, according to background information in the article.
Barbara E. K. Klein, M.D., M.P.H., of the University of Wisconsin School of Medicine and Public Health, Madison, and colleagues analyzed data from the Beaver Dam Eye Study to determine if statin use is associated with a reduced risk of age-related cataract. The analysis included 1,299 persons who were examined as part of the study in 1998-2000 and were deemed to be at risk of developing nuclear cataract within 5 years.
A total of 210 persons developed incident nuclear cataract in the interval from 1998-2000 to 2003-2005. The five-year incidence of nuclear cataract was 12.2 percent in statin users compared with 17.2 percent in nonusers; the odds of developing cataract were 40 percent lower for statin users after adjusting for several factors. Because smoking and diabetes increase risk of nuclear cataract, the authors analyzed results in never smokers without diabetes, and found the odds of developing nuclear cataract was 60 percent lower among statin users after adjusting for other factors. The incidence of two other types of cataracts, cortical and posterior subcapsular cataracts, did not differ significantly between statin users and nonusers.
To further explore the relationship between statin use and nuclear cataract, the authors suggest that clinical trials of statins used for lipid lowering should assess nuclear cataract. In addition, they state "further study of the relationship of cataract and statin use is needed in which each type of cataract is considered individually. Further follow-up of our cohort, with anticipated increase in number of persons with cataract and wider use of statins, will permit us to evaluate whether our finding persists."
(JAMA. 2006;295:2752-2758. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: The National Eye Institute provided funding for the entire study; Research to Prevent Blindness, New York, N.Y., provided further additional support for data analyses.
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JAMA