Relationships between hormonal status and cataract in french postmenopausal women: the POLA study

Purpose Prevalence rate of cataract is higher in women than in men. Sex hormones have been hypothesized to be linked with this gender difference. Our aim is to study the relationships between hormonal status and cataract in postmenopausal women. Methods The Pathologies Oculaires Liées à lʹAge (POLA) study is a population-based study on age-related eye diseases and their risk factors, in 2584 residents of Sète (France). Cataract classification was based on a standardized lens examination, according to Lens Opacities Classification System III. Biological measurements were performed from fasting blood samples. We conducted a cross-sectional study in the female participants (n = 1451) aged over 60 years. Results No association of hormone replacement therapy (HRT) with any type of cataract was found, but an increased risk of cataract surgery was observed in women with a long duration of hormone therapy (greater-or-equal, slanted5 years) (multivariate-adjusted odds ratio (OR) = 3.80; 95% CI: 1.45–9.94). Globally, the risk for cataract (any type) was not associated with a long duration of HRT use (OR = 1.06; 95% CI: 0.64–1.74). After multivariate adjustment, oophorectomy was associated with a reduced risk of cataract (OR = 0.60; 95% CI = 0.38–0.94). In the multivariate model, no association was found between estradiol, total testosterone or sex-hormone–binding globulin and cataract. However, high levels of dehydroepiandrosterone sulfate (DHEAS) were associated with a reduced risk of cataract (OR=0.79; 95% CI: 0.63–0.99). Conclusion HRT use was not associated with cataract. A reduced risk of cataract was found in oophorectomized women and in women with high DHEAS levels.