Association Between Cataract and Risks of Osteoporosis and Fracture: A Nationwide Cohort Study

OBJECTIVES: To evaluate the association between cataract and cataract surgery and risks of osteoporosis and fracture. DESIGN: Nationwide population-based retrospective cohort study. SETTING: Taiwan's National Health Insurance Research Database. PARTICIPANTS: Individuals with (n=57,972) and without (n=57,972) cataracts. MEASUREMENTS: Individuals with and without cataracts were matched 1:1 for age, sex, and index year. Those with cataracts were further divided into cataract surgery and nonsurgery groups. Incidences and hazard ratios (HR) for risks of developing osteoporosis and fracture were calculated using Cox proportional hazard regression models. RESULTS: During mean follow-up of 6.4 years, 17,450 participants with cataracts and 12,627 without developed osteoporosis or fractures. Having cataracts was significantly associated with risk of developing osteoporosis or fracture (adjusted HR (aHR) = 1.29, 95% confidence interval (CI) = 1.25-1.32, p < .001). In analyses for each event, cataract was significantly associated with greater likelihood of all outcomes (osteoporosis: aHR = 1.43, 95% CI = 1.37-1.50, p < .001; hip fracture: aHR = 1.16, 95% CI = 1.07-1.26, p < .001; vertebral fracture: (aHR = 1.25, 95% CI = 1.18-1.33, p < .001; other fractures: aHR = 1.24, 95% CI = 1.20-1.28, p < .001). Participants who underwent cataract surgery were at significantly lower risk of osteoporosis or fracture (aHR = 0.58, 95% CI = 0.56-0.59, p < .001), than those who did not. Undergoing cataract surgery was also associated with lower risks of all individual events (osteoporosis; hip, vertebral, other fracture). CONCLUSION: Cataract was independently associated with increased risks of osteoporosis and fracture. There might be an association between cataract surgery and lower risks of osteoporosis and fracture.