TOPLINE

Cardiovascular-kidney-metabolic (CKM) syndrome — a condition spanning heart, kidney, and metabolic health — was linked to increased risks for cataract, glaucoma, and age-related macular degeneration in a UK Biobank analysis. Stage 3 CKM syndrome showed the strongest associations, with more than double the risk for cataract and age-related macular degeneration and a 76% higher risk for glaucoma, compared with stage 0.

METHODOLOGY

• Researchers tracked more than 412,000 UK Biobank participants aged 40-69 years for over a decade to examine whether CKM syndrome is linked to major blinding eye diseases.
• Each participant's CKM status at baseline was classified into one of five stages, ranging from stage 0 (no risk factors) to stage 4 (established cardiovascular disease).
• Outcome measures included incident cataract, glaucoma, and age-related macular degeneration, ascertained using standard diagnosis codes from linked UK Biobank health records — including hospital inpatient and primary care records.
• Because each eye disease was analyzed separately, the researchers further excluded participants who already had the relevant condition at baseline, yielding three outcome-specific cohorts: 404,600 participants for cataract, 410,563 for glaucoma, and 411,452 for age-related macular degeneration.
• Statistical models were used to calculate risk levels across stages of CKM syndrome and examine whether the associations varied by age, sex, race, smoking, education, and use of alcohol and steroids.

TAKEAWAY

• During follow-up, 50,894 incident cases of cataract, 11,518 incident cases of glaucoma, and 8708 incident cases of age-related macular degeneration were documented.
• Incidence rates of cataract, glaucoma, and age-related macular degeneration all rose with CKM stage and peaked at stage 3 — climbing from 5.15 to 26.80 per 1000 person-years for cataract, 1.17 to 4.39 per 1000 person-years for glaucoma, and 0.81 to 4.06 per 1000 person-years for age-related macular degeneration.
• Compared with stage 0, stage 3 CKM syndrome was associated with more than double the risk for cataract (hazard ratio [HR], 2.25; P < .001) and age-related macular degeneration (HR, 2.08; P < .001) and a 76% higher risk for glaucoma (HR, 1.76; P < .001).
• Subgroup analyses showed generally consistent associations across population strata, although the link between stage 3 CKM syndrome and eye disease was stronger among participants younger than 65 years for all three conditions and among men and non-White participants for cataract.

IN PRACTICE

"Cardiometabolic and kidney dysfunction have been linked to chronic inflammation, oxidative stress, endothelial dysfunction and microvascular impairment, which may adversely affect retinal and optic nerve perfusion," the researchers reported.

"However, the present study was observational and cannot establish causality or underlying biological mechanisms," they added.

SOURCE

The study was led by Yican Ying, Renyu Li, and Jinqi Huang, all from the Cardio-Oncology Group, of the Medical Exploration and Translation Team in Guangzhou, China. It was published online on August 26 in Eye.

LIMITATIONS

The causal relationship between CKM syndrome and the risk of blinding eye disease could not be established because of the observational design. Ocular outcomes were identified using diagnostic codes rather than actual eye exams, which may have led to some cases being missed or misclassified. Certain unmeasured factors could still be influencing the results, even after the adjustments.

DISCLOSURES

This study was supported by grants from the National Natural Science Foundation of China, Guangdong Basic and Applied Basic Research Foundation, China Postdoctoral Science Foundation, and other organizations. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.