Metabolic, Familial, and Environmental Factors Associated With Cataract in Young Bangladeshi Adults: A Hospital-Based Matched Case-Control Study
6 affiliations
- 1Department of Biochemistry, Shaheed Suhrawardy Medical College and Hospital, Dhaka, BGD
- 2Department of Biochemistry, Shaheed Tajuddin Ahmad Medical College, Gazipur, BGD
- 3Department of Biochemistry, Dhaka Medical College Hospital, Dhaka, BGD
- 4Department of Pathology, National Institute of Opthalmology and Hospital, Dhaka, BGD
- 5Department of Biochemistry, Sir Salimullah Medical College Mitford Hospital, Dhaka, BGD
- 6Department of Biochemistry, University of Science and Technology Chittagong (USTC), Chattogram, BGD
Abstract
Background
Cataract is traditionally regarded as a disease of advanced age, but it is also encountered in young adults, in whom the metabolic and biochemical determinants of lens opacification remain poorly characterized. This study aimed to evaluate the sociodemographic, environmental, ocular, metabolic, and biochemical factors associated with cataracts in young Bangladeshi adults.
Methods
In this hospital-based matched case-control study, which was conducted at the National Institute of Ophthalmology and Hospital and the Department of Biochemistry, Dhaka Medical College, between July 2025 and June 2026, 40 adults with ophthalmologist-confirmed cataracts and 40 age- and sex-matched controls without lens opacity, drawn from patients attending the OPD of the same hospital for other eye complaints, were enrolled via purposive sampling. Exposures were recorded through structured face-to-face interviews, and fasting serum calcium (total calcium, not corrected for albumin), 25-hydroxyvitamin D, electrolytes, glucose, and lipid profiles were measured. Independent associations were estimated via multivariable logistic regression with Firth's penalized likelihood to reduce small-sample bias, followed by sensitivity analyses.
Results
Cases and controls had an identical mean age (37.4 ± 8.0 years) and sex distribution (23/40, 57.5% female in each group). Cataract was significantly associated with rural residence (16/40, 40.0% vs 4/40, 10.0%), biomass fuel use (28/40, 70.0% vs 14/40, 35.0%), diabetes mellitus (13/40, 32.5% vs 1/40, 2.5%), and family history of cataracts (21/40, 52.5% vs 5/40, 12.5%; all p < 0.01). Mean serum calcium, sodium, and potassium levels were lower, and fasting glucose levels were higher among cases (all p < 0.05). Hypocalcemia based on total serum calcium (13/40, 32.5% vs 3/40, 7.5%) and hypertriglyceridemia (21/40, 52.5% vs 8/40, 20.0%) were more common among cases, whereas vitamin D status and cholesterol fractions did not differ. After adjustment, hypocalcemia (adjusted OR (aOR) 17.64, 95% CI 3.08-147.60), diabetes mellitus (aOR 15.71, 95% CI 1.93-276.31), family history (aOR 11.76, 95% CI 2.77-69.20), hypertriglyceridemia (aOR 8.51, 95% CI 1.99-52.69), and rural residence (aOR 6.55, 95% CI 1.04-59.96) remained independently associated with cataracts, although CIs were wide, particularly for diabetes mellitus, reflecting the small sample size. The metabolic and familial associations persisted in all sensitivity analyses, including one restricted to urban participants, whereas the association with rural residence was of borderline significance in the main model and did not remain significant in any of the three sensitivity analyses in which it could be assessed; therefore, it should be interpreted cautiously.
Conclusions
Low total serum calcium (hypocalcemia), diabetes mellitus, family history of cataracts, and hypertriglyceridemia were independently associated with early-onset cataracts in young Bangladeshi adults. Without albumin correction or ionized calcium measurement, the hypocalcemia finding is preliminary. The association with rural residence was not robust in sensitivity analyses, possibly reflecting control selection. If confirmed, fasting glucose, serum calcium, and triglyceride levels may help identify young adults for closer eye examination. These case-control findings indicate associations, not causation, and require prospective confirmation.
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BibTeX
@article{afrin2026metabolic,
title = {{Metabolic, Familial, and Environmental Factors Associated With Cataract in Young Bangladeshi Adults: A Hospital-Based Matched Case-Control Study}},
author = {Jeenia Afrin and Rehnuma Bushra and Neelufar Sultana Chowdhury and Md. Sadrul Alam Hafiz and Md. Nazrul Islam Chowdhury and Most. Tasnima Akhter and Tanvia Zahin and Isma Johora},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117208},
url = {https://europepmc.org/article/PMC/PMC13721026},
note = {CC BY},
}
RIS
TY - JOUR
TI - Metabolic, Familial, and Environmental Factors Associated With Cataract in Young Bangladeshi Adults: A Hospital-Based Matched Case-Control Study
AU - Jeenia Afrin
AU - Rehnuma Bushra
AU - Neelufar Sultana Chowdhury
AU - Md. Sadrul Alam Hafiz
AU - Md. Nazrul Islam Chowdhury
AU - Most. Tasnima Akhter
AU - Tanvia Zahin
AU - Isma Johora
PY - 2026
DA - 2026/09/30
JO - Cureus
DO - 10.7759/cureus.117208
UR - https://europepmc.org/article/PMC/PMC13721026
AB - Background Cataract is traditionally regarded as a disease of advanced age, but it is also encountered in young adults, in whom the metabolic and biochemical determinants of lens opacification remain poorly characterized. This study aimed to evaluate the sociodemographic, environmental, ocular, metabolic, and biochemical factors associated with cataracts in young Bangladeshi adults. Methods In this hospital-based matched case-control study, which was conducted at the National Institute of Ophthalmology and Hospital and the Department of Biochemistry, Dhaka Medical College, between July 2025 and June 2026, 40 adults with ophthalmologist-confirmed cataracts and 40 age- and sex-matched controls without lens opacity, drawn from patients attending the OPD of the same hospital for other eye complaints, were enrolled via purposive sampling. Exposures were recorded through structured face-to-face interviews, and fasting serum calcium (total calcium, not corrected for albumin), 25-hydroxyvitamin D, electrolytes, glucose, and lipid profiles were measured. Independent associations were estimated via multivariable logistic regression with Firth's penalized likelihood to reduce small-sample bias, followed by sensitivity analyses. Results Cases and controls had an identical mean age (37.4 ± 8.0 years) and sex distribution (23/40, 57.5% female in each group). Cataract was significantly associated with rural residence (16/40, 40.0% vs 4/40, 10.0%), biomass fuel use (28/40, 70.0% vs 14/40, 35.0%), diabetes mellitus (13/40, 32.5% vs 1/40, 2.5%), and family history of cataracts (21/40, 52.5% vs 5/40, 12.5%; all p < 0.01). Mean serum calcium, sodium, and potassium levels were lower, and fasting glucose levels were higher among cases (all p < 0.05). Hypocalcemia based on total serum calcium (13/40, 32.5% vs 3/40, 7.5%) and hypertriglyceridemia (21/40, 52.5% vs 8/40, 20.0%) were more common among cases, whereas vitamin D status and cholesterol fractions did not differ. After adjustment, hypocalcemia (adjusted OR (aOR) 17.64, 95% CI 3.08-147.60), diabetes mellitus (aOR 15.71, 95% CI 1.93-276.31), family history (aOR 11.76, 95% CI 2.77-69.20), hypertriglyceridemia (aOR 8.51, 95% CI 1.99-52.69), and rural residence (aOR 6.55, 95% CI 1.04-59.96) remained independently associated with cataracts, although CIs were wide, particularly for diabetes mellitus, reflecting the small sample size. The metabolic and familial associations persisted in all sensitivity analyses, including one restricted to urban participants, whereas the association with rural residence was of borderline significance in the main model and did not remain significant in any of the three sensitivity analyses in which it could be assessed; therefore, it should be interpreted cautiously. Conclusions Low total serum calcium (hypocalcemia), diabetes mellitus, family history of cataracts, and hypertriglyceridemia were independently associated with early-onset cataracts in young Bangladeshi adults. Without albumin correction or ionized calcium measurement, the hypocalcemia finding is preliminary. The association with rural residence was not robust in sensitivity analyses, possibly reflecting control selection. If confirmed, fasting glucose, serum calcium, and triglyceride levels may help identify young adults for closer eye examination. These case-control findings indicate associations, not causation, and require prospective confirmation.
SN - 2168-8184
ER -