Characterization of Biochemical Risk Factors of Senile Cataract Among Adults Visiting Komfo Anokye Teching Hospital, Kumasi, Ghana.

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Senile Cataract, the opacity of the lens due to age is a major public health problem which if not detected and treated early could lead to blindness and other morbidities. It is the leading cause of avoidable blindness in Ghana. However, there are few repo rts on the biochemical risk factors elsewhere and no such study report could be found in Ghana. The study seeks to identify and characterized the biochemical risk factors for senile cataract among Ghanaian adults and to elucidate the association between serum biochemical indices and senile cataract for future cataract prognosis, screening program and to develop appropriate preventive strategies. This was a case-control study of outpatients attending eye clinic department of the Komfo Anokye Teaching Hospital (KATH) between February 2009 and July 2010. A total of 200 outpatients above 40 years comprising 100 cases (clinically newly diagnosed adult cataract patients) and 100 controls (patients who are clinically without the condition) were sampled for the study. Laboratory test values in cases and controls were compared and expressed as odds ratio and 95% confidence interval. The study found mean concentration of fasting blood glucose (4.92±2.09 mmol/L) of the cases was lower than the control grouping but within the normal reference ranges and was associated with senile cataract (ORs (95% CI) 1.3; 1.O6-1.49; p=0.008). There was elevated serum Na + level in those suffering from senile cataract (143.2±6.76 mmol/L) than the controls (139.3±1.96; p=0.0000). It was significant factor associated with the senile cataract (ORs (95% CI) 0 6 95% CI (0.47-0.72; p=0.000)). vi The mean serum K + level (4.21±0.50 mmol/L) of senile cataract patients was lower than the controls (4.38±0.45) and also associated with senile cataract with ORs (95% CI) 2.48 (1.47-0.72; p=0.010). Persons with low HDL C abnormalities have ORs (95% CI) 3.17 (1.79-5.61; p=0.000) and were significantly associated with senile cataract among the study population. The mean uric acid concentrations level was (210.0±113.8μmol L-1) lower in the cases compared with (311.1±117μmol L-1) controls and was significantly associated with senile cataract among the study population (ORs (95% CI) 1.01 (1.01-1.02) P=0.000). After adjusting for potential confounders, fasting blood glucose (ORs (95% CI) 1.O6 -1.49 ;p=0.008), sodium (Na + ) ORs (95% CI) 0 6 (0.47-0.72; p=0.000), potassium (K + ) ORs (95% CI) 2.48 (1.47-0.72; p=0.010), triglyceride (TG) ORs (95% CI) 0.58 (0.35-0.98) p=0.040), uric acid (UA) ORs (95% CI) 1.01 (1.01-1.02) P=0.000) and high density lipoprotein-Cholesterol ( HDL-c) ORs (95% CI) 3.17 (1.79-5.61; p=0.000) were identify and characterized as a significantly human biochemical indices associated with development of senile cataract among the study population. In log Likelihood-ratio test (LRTEST) controlling for age and sex, e levated serum Na+ level in those suffering from senile cataract was significant factor associated with senile cataract ORs (95% CI) 0.60 (0.45 - 0.80), P=0.001). Persons with lower serum potassium (K + ) ORs (95% CI) 2.48 (1.47-0.72; p=0.010) are twice likely to develop senile cataract. Persons with low HDL CHOL abnormalities were twice likely to develop senile cataract (ORs (95% CI), 2.52 p=0.095). The trend LRTEST indicated a very strong association between increasing order of level of exposure to (Na + ), HDL-c, UA, FBG and the probability of developing the senile cataract.The studies clearly established a half (50%) of any study population with the age of ≥70 years especially women are most likely to develop senile cataract. This study strongly suggests an association between serum biochemical indices and senile cataract. The association exist between low levels of High Density Lipoprotein-cholesterol (HDL) , low levels uric acid, Fasting blood Glucose(FBG), Serum sodium ( Na+), serum potassium ( K+), Triglyceride (TG) and Senile cataract. Our findings add to an evolving biochemical and laboratory animal based hypothesis that changes observed in the blood level constituent raised or lowered can be used for diagnostic and prognostic purposes and their detection makes up a large part of routine clinical chemistry especially in an elective cataract surgery procedure. It is essential to have access to the biochemical picture of such a patient prior to, during and immediately after surgery in order to effectively treat adverse reactions and that further studies may be necessary to ascertain whether or not certain dietary habit has a part to play in the aetiogenesis of Senile Cataract in various regions of Ghana.
A thesis submitted to the Department of Molecular Medicine, School of Medical Sciences. Kwame Nkrumah University of Science and Technology in partial fulfillment for the degree of Master of Science.