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  • 1.
    Asplund, R.
    et al.
    Family Medicine Stockholm, Karolinska Institute, Huddinge, Sweden; Research and Development Unit, Jämtland County Council, Östersund, Sweden.
    Lindblad, Birgitta Ejdervik
    Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Sleep and sleepiness 1 and 9 months after cataract surgery2004In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 38, no 1, p. 69-75Article in journal (Refereed)
    Abstract [en]

    This study was undertaken to analyze sleep development in a group of patients during the first 9 months after cataract extraction. Men and women (n=407) undergoing cataract surgery at the Department of Ophthalmology, Sundsvall Hospital during two periods in 2000-2002 were asked to complete a questionnaire on the state and change of sleep and sleepiness 1 and 9 months after the operation. The response rate was 90.8%. The mean ages of the participating men and women were 74.5 and 75.6 years, respectively. One week after cataract extraction the visual acuity in the treated eye was 0.67 (+/-0.31) in men and 0.69 (+/-0.28) in women (NS), and showed an inverse relationship to age in both men (P<0.01) and women (P<0.0001). One month after cataract extraction 28.3% of the men and 37.5% of the women experienced poor sleep, and after 9 months the figures were 15.8 and 31.4%, respectively. Frequent awakenings and difficulty in falling asleep after nocturnal awakenings improved correspondingly. Being well rested in the morning increased and daytime sleepiness decreased. The results indicate that in elderly persons with cataract sleep is improved 1 month after cataract extraction and further improvement during the first 9 months may be experienced.

  • 2.
    Asplund, R.
    et al.
    Family Medicine Stockholm, Karolinska Institute, Huddinge, Sweden; Research and Development Unit (Forsknings- och utvecklingsenheten), Jämtland County Council, Östersund, Sweden.
    Lindblad, Birgitta Ejdervik
    Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    The development of sleep in persons undergoing cataract surgery2002In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 35, no 2, p. 179-187Article in journal (Refereed)
    Abstract [en]

    This study was undertaken in order to analyse sleep in a group of patients who were operated on for cataract. All patients (n=328) undergoing cataract surgery at the Department of Ophthalmology, Sundsvall Hospital during a 4-month period were asked to complete a questionnaire on the state and change of sleep and sleepiness 1 month after the operation. Twelve persons were unable or declined to participate. The response rate was 97.2%. The mean ages of the participating men and women were 74.5 and 76.3 years, respectively. Pre-operative visual acuity in the operated eye was 0.16 in men and 0.18 in women. After cataract extraction sleep was improved in 12.0% of the men and in 26.3% of the women. Nevertheless poor sleep 1 month post-operatively was reported by 29.3% of the men and 42.6% of the women (P<0.05). There was no age-related increase in sleep complaints. The results indicate that in elderly persons with cataract sleep is impaired, and that 1 month after cataract extraction improved sleep may be experienced.

  • 3.
    Ejdervik Lindblad, Birgitta
    et al.
    Örebro University, School of Medical Sciences. Department of Ophthalmology.
    Håkansson, Niclas
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wolk, Alicja
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Metabolic syndrome and some of its components in relation to risk of cataract extraction: A prospective cohort study of men2019In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 97, no 4, p. 409-414Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the relationship between metabolic syndrome and some of its components with the incidence of cataract extraction.

    METHODS: A population-based prospective cohort with a total of 45 049 men, aged 45-79 years, from the Cohort of Swedish Men completed in 1997 a self-administered questionnaire concerning anthropometric measurements and lifestyle factors. The men were followed from 1 January 1998 through 31 December 2012, and the cohort was matched with registers of cataract extraction. The main outcome measure was incident cases of age-related cataract extraction.

    RESULTS: Over the 15-years of follow-up, 7573 incident cases of cataract extraction were identified. After controlling for potential confounders, the association between single components of metabolic syndrome, abdominal adiposity, diabetes and hypertension and risk of cataract extraction was rate ratio (RR): 1.04; 95% confidence interval (CI): 0.99-1.10, RR: 1.77; 95% CI: 1.64-1.92 and RR: 1.06; 95% CI 1.00-1.13, respectively. The risk of cataract extraction increased with increasing numbers of metabolic syndrome components (p < 0.0001). Men aged 65 years or younger at baseline with all three components of the metabolic syndrome had a relative risk of 2.43 (95% CI: 1.95-3.01) for cataract extraction.

    CONCLUSION: In this cohort of middle-aged and elderly men, metabolic syndrome with the combination of abdominal adiposity, diabetes and hypertension was associated with an increased risk for cataract extraction, especially among men aged 65 years or younger. These findings put emphasis on the importance of weight control and healthy lifestyle behaviours in order to prevent cataract.

  • 4. Elefteria, Dhima
    et al.
    Ejdervik Lindblad, Birgitta
    Örebro University, School of Medical Sciences.
    Central serous chorioretinopathy as a first sign of severe undiagnosed SLE in a pregnant woman2017Conference paper (Refereed)
  • 5.
    Lindblad, Birgitta Ejdervik
    et al.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Håkansson, Niclas
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Philipson, Bo
    Stockholm Eye Clinic, H.M. Queen Sophia Hospital, Stockholm, Sweden.
    Wolk, Alicja
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Alcohol consumption and risk of cataract extraction: a prospective cohort study of women2007In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 114, no 4, p. 680-685Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate the association between alcohol consumption and the risk of cataract extraction.

    DESIGN: Population-based prospective cohort study.

    PARTICIPANTS: A total of 34,713 women participating in the Swedish Mammography Cohort, age 49 to 83 years, completed in 1997 a self-administered questionnaire about alcohol, smoking, and other lifestyle factors.

    METHODS: The women were followed from September 1997 through September 2004. The cohort was matched with registers of cataract extraction from the study area.

    MAIN OUTCOME MEASURES: Incident surgical extraction of age-related cataract.

    RESULTS: During 84 months of follow-up, we found 3587 incident cases of age-related cataract extraction. Compared with never drinkers, the relative risk of cataract extraction among current drinkers was 1.11 (95% confidence interval [CI] 1.02-1.21) after adjustment for age and other potential risk factors. In multivariate analysis, an increment of 13 g alcohol intake per day (corresponding to 1 drink = 330 ml of beer, 150 ml of wine, or 45 ml of liquor) was associated with a 7% increased risk of cataract extraction (relative risk, 1.07; 95% CI 1.02-1.12). Mean age at cataract extraction among nonsmoking women who used alcohol was 75 years, compared with 77.6 years among never drinkers.

    CONCLUSIONS: These prospective data suggest that daily use of >/=1 alcoholic drinks was associated with a modest increase of risk for cataract extraction. The risk increased with increasing alcohol consumption.

  • 6.
    Lindblad, Birgitta Ejdervik
    et al.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Håkansson, Niclas
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Philipson, Bo
    Stockholm Eye Clinic, H.M. Queen Sophia Hospital, Stockholm, Sweden.
    Wolk, Alicja
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Hormone replacement therapy in relation to risk of cataract extraction: a prospective study of women2010In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 117, no 3, p. 424-430Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the association between hormone replacement therapy (HRT) and the incidence of cataract extraction among postmenopausal women.

    DESIGN: Population-based, prospective cohort study.

    PARTICIPANTS: A total of 30 861 postmenopausal women participating in the Swedish Mammography Cohort, age 49 to 83 years, who completed a self-administered questionnaire in 1997 about hormone status, HRT, and lifestyle factors.

    METHODS: The women were followed from September 1997 through October 2005. The cohort was matched with registers of cataract extraction in the study area.

    MAIN OUTCOME MEASURES: Incident operative extraction of age-related cataract.

    RESULTS: We identified 4324 incident cases of cataract extractions during 98 months of follow-up. In multivariate adjusted analysis, ever use of HRT was associated with a 14% increased risk of cataract extraction (rate ratio [RR], 1.14; 95% confidence interval [CI], 1.07-1.21) compared with those who never used HRT. Current use of HRT was associated with an 18% increased risk of cataract extraction (RR, 1.18; 95% CI, 1.10-1.26). A significant linear trend was observed where increasing duration of HRT usage resulted in an increased risk of cataract extraction (P for trend = 0.006). Multivariate RR for current HRT usage for >10 years was 1.20 (95% CI, 1.06-1.36; P for trend = 0.001). Among women drinking on average >1 drink of alcohol per day, current HRT users had a 42% increased risk (RR, 1.42; 95% CI, 1.11-1.80) for cataract extraction, compared with women who neither used HRT nor alcohol. The risk of cataract extraction among current users of HRT was similar among current smokers and those who never smoked.

    CONCLUSIONS: Our prospective, population-based study indicates that postmenopausal women using HRT for a long period of time may be at an increased risk for cataract extraction, especially those drinking >1 alcoholic drink daily.

  • 7.
    Lindblad, Birgitta Ejdervik
    et al.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Håkansson, Niclas
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Philipson, Bo
    Stockholm Eye Clinic, H. M. Queen Sophia Hospital, Stockholm, Sweden.
    Wolk, Alicja
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Metabolic syndrome components in relation to risk of cataract extraction: a prospective cohort study of women2008In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 115, no 10, p. 1687-1692Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the association between metabolic syndrome and some of its components with the incidence of cataract extraction.

    DESIGN: Population-based prospective cohort study.

    PARTICIPANTS: A total of 35,369 women, participating in the Swedish Mammography Cohort, aged 49 to 83 years, who completed a self-administered questionnaire about anthropometric measurements and lifestyle factors in 1997.

    METHODS: The women were followed from September of 1997 to October of 2005. The cohort was matched with registers of cataract extraction in the study area.

    MAIN OUTCOME MEASURES: Incident surgical extraction of age-related cataract.

    RESULTS: We identified 4508 incident cases of cataract extractions during 98 months of follow-up. In multivariate analysis, women with a waist circumference >or=80 cm had an 8% increased risk of cataract extraction (rate ratio [RR], 1.08; 95% confidence interval [CI], 0.99-1.17). Women with diabetes had a 43% increased risk of cataract extraction (RR, 1.43; 95% CI, 1.10-1.86), and hypertension was associated with a 12% increased risk (RR, 1.12; 95% CI, 0.99-1.26). Women with all 3 components of the metabolic syndrome (waist >or=80 cm, diabetes, and hypertension) had a 68% increased risk of cataract extraction (RR, 1.68; 95% CI, 1.40-2.02) compared with women without any of these components. Among women aged less than 65 years at baseline with all 3 components of metabolic syndrome, the risk of cataract extraction was approximately 3-fold more (RR, 2.80; CI, 1.94-4.03).

    CONCLUSIONS: Metabolic syndrome and its components, abdominal adiposity, diabetes, and hypertension, seem to be associated with an increased risk for cataract extraction, especially among women aged less than 65 years.

  • 8.
    Lindblad, Birgitta Ejdervik
    et al.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Håkansson, Niclas
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Svensson, Hanna
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Philipson, Bo
    Stockholm Eye Clinic, H. M. Queen Sophia Hospital, Stockholm, Sweden.
    Wolk, Alicja
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Intensity of smoking and smoking cessation in relation to risk of cataract extraction: a prospective study of women2005In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 162, no 1, p. 73-79Article in journal (Refereed)
    Abstract [en]

    The authors investigated the association of smoking and smoking cessation with the incidence of cataract extraction in a population-based prospective cohort study. A total of 34,595 women aged 49-83 years in the Swedish Mammography Cohort were followed from September 1997 through June 2002. Information on smoking, diet, and other lifestyle factors was collected through a self-administered questionnaire. A total of 2,128 cases of age-related cataract extraction were identified. Relative risks were estimated as rate ratios using Cox proportional hazards models. The authors observed a significant dose-response association between intensity of smoking and risk of cataract extraction (among current smokers, p for trend = 0.02; among past smokers, p for trend = 0.0002). After cessation of smoking, the risk decreased with time. Among women with a moderate lifetime smoking intensity (6-10 cigarettes/day), the relative risk was not significantly different from the risk among never smokers 10 years after smoking cessation. Among women who had smoked more intensively (>10 cigarettes/day), after 20 years of nonsmoking the increased risk became small and no longer statistically significant in comparison with never smokers (for trend over time, p < 0.0001). This prospective study confirmed smoking as a risk factor for cataract, with a dose response for smoking intensity. Smoking cessation predicts reduced risk over time, but a longer period of time is needed with a higher smoking intensity.

  • 9.
    Lindblad, Birgitta Ejdervik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Håkansson, Niclas
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wolk, Alicja
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Smoking cessation and the risk of cataract: a prospective cohort study of cataract extraction among men2014In: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 132, no 3, p. 253-7Article in journal (Refereed)
    Abstract [en]

    Importance: Smoking is a risk factor for cataract development, but the effect of smoking cessation on the risk of cataract is uncertain.

    Objective: To examine the association between smoking cessation and the risk of cataract extraction.

    Design, setting, and participants: A total of 44,371 men, participating in the Cohort of Swedish Men, aged 45 to 79 years, who in 1997 completed a self-administered questionnaire on smoking habits and lifestyle factors. The men were followed up from January 1, 1998, through December 31, 2009. The cohort was matched with the Swedish National Day-Surgery Register and local registers of cataract extraction in the study area.

    Main outcomes and measures: Incident cases of age-related cataract extraction.

    Results: During 12 years of follow-up, we identified 5713 incident cases of age-related cataract extraction. Smoking intensity and cumulative dose of smoking were associated with an increased risk of cataract extraction (P for trend <.001). Current smokers of more than 15 cigarettes per day had a 42% increased risk of cataract extraction (rate ratio, 1.42; 95% CI, 1.28-1.58) compared with never smokers after adjustment for age and other potential risk factors. Smoking cessation significantly decreased the risk for cataract extraction with time (P for trend <.001). After more than 20 years since stopping smoking, men with a mean smoking intensity of more than 15 cigarettes per day had a 21% increased risk of cataract extraction (rate ratio, 1.21; 95% CI, 1.06-1.39) compared with never smokers. Among men who smoked 15 cigarettes or less per day, the effect of smoking cessation was observed earlier, but more than 2 decades after smoking cessation, the risk of cataract extraction did not decrease to the level of never smokers (rate ratio, 1.13; 95% CI, 1.04-1.24).

    Conclusion and relevance: Smoking cessation seems to decrease the risk of cataract extraction with time, although the risk persists for decades. The higher the intensity of smoking, the longer it takes for the increased risk to decline. These findings emphasize the importance of early smoking cessation and preferably the avoidance of smoking.

  • 10.
    Mollazadegan, Kaziwe
    et al.
    Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Eugeniahemmet, Stockholm, Sweden.
    Kugelberg, Maria
    St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
    Lindblad, Birgitta Ejdervik
    Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Ludvigsson, Jonas F.
    Örebro University, School of Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Eugeniahemmet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Increased risk of cataract among 28,000 patients with celiac disease2011In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 174, no 2, p. 195-202Article in journal (Refereed)
    Abstract [en]

    Vitamin deficiencies are prevalent in celiac disease (CD) and are associated with cataract formation, but it is unknown whether persons with CD are at increased risk of cataract. The authors' objective in this population-based cohort study was to determine the risk of cataract among persons with biopsy-verified CD. Data on CD were collected from reports on small intestinal biopsies performed between July 1969 and February 2008 in the 28 regional pathology departments in Sweden. The authors identified 28,756 persons with CD (villous atrophy, Marsh pathology stage 3). For each person with CD, Statistics Sweden selected up to 5 controls matched for age and sex from the Total Population Register. Data on cataract were obtained from the Swedish National Hospital Discharge Register and the National Day-Surgery Register. Cox regression analysis was used to estimate the risk of cataract. During a median follow-up period of 9 years, the authors identified 1,159 cataracts among persons with CD (909 were expected) (hazard ratio = 1.28, 95% confidence interval: 1.19, 1.36). The absolute risk of cataract was 397/100,000 person-years in CD, with an excess risk of 86/100,000 person-years. In conclusion, this study found an increased risk of developing cataract in patients with CD.

  • 11.
    Rautiainen, Susanne
    et al.
    Inst Environm Med, Div Nutr Epidemiol, Karolinska Inst, Stockholm, Sweden.
    Lindblad, Birgitta Ejdervik
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
    Morgenstern, Ralf
    Inst Environm Med, Div Biochem Toxicol, Karolinska Inst, Stockholm, Sweden.
    Wolk, Alicja
    Inst Environm Med, Div Nutr Epidemiol, Karolinska Inst, Stockholm, Sweden.
    Total Antioxidant Capacity of the Diet and Risk of Age-Related Cataract A Population-Based Prospective Cohort of Women2014In: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 133, no 3, p. 247-252Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: To our knowledge, no previous epidemiologic study has investigated the association between all antioxidants in the diet and age-related cataract. The total antioxidant capacity (TAC) concept aims to measure the capacity from all antioxidants in the diet by also taking synergistic effects into account.

    OBJECTIVE: To investigate the association between the TAC of the diet and the incidence of age-related cataract in a population-based prospective cohort of middle-aged and elderly women.

    DESIGN, SETTING, AND PARTICIPANTS: Questionnaire-based nutrition survey within the prospective Swedish Mammography Cohort study, which included 30 607 women (aged 49-83 years) who were observed for age-related cataract incidence for a mean of 7.7 years.

    EXPOSURE: The TAC of the diet was estimated using a database of foods analyzed with the oxygen radical absorbance capacity assay.

    MAIN OUTCOMES AND MEASURES: Information on incident age-related cataract diagnosis and extraction was collected through linkage to registers in the study area.

    RESULTS: There were 4309 incident cases of age-related cataracts during the mean 7.7 years of follow-up (234 371 person-years). The multivariable rate ratio in the highest quintile of the TAC of the diet compared with the lowest was 0.87 (95% CI, 0.79-0.96; P for trend = .03). The main contributors to dietary TAC in the study population were fruit and vegetables (44.3%), whole grains (17.0%), and coffee (15.1%).

    CONCLUSIONS AND RELEVANCE: Dietary TAC was inversely associated with the risk of age-related cataract. Future studies examining all antioxidants in the diet in relation to age-related cataract are needed to confirm or refute our findings.

  • 12.
    Rautiainen, Susanne
    et al.
    Divisions of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lindblad, Birgitta Ejdervik
    Divisions of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Morgenstern, Ralf
    Biochemical Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wolk, Alicja
    Divisions of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Vitamin C supplements and the risk of age-related cataract: a population-based prospective cohort study in women2010In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 91, no 2, p. 487-93Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Experimental animal studies have shown adverse effects of high-dose vitamin C supplements on age-related cataract.

    OBJECTIVE: We examined whether vitamin C supplements (approximately 1000 mg) and multivitamins containing vitamin C (approximately 60 mg) are associated with the incidence of age-related cataract extraction in a population-based, prospective cohort of women.

    DESIGN: Our study included 24,593 women aged 49-83 y from the Swedish Mammography Cohort (follow-up from September 1997 to October 2005). We collected information on dietary supplement use and lifestyle factors with the use of a self-administrated questionnaire. Cataract extraction cases were identified by linkage to the cataract extraction registers in the geographical study area.

    RESULTS: During the 8.2 y of follow-up (184,698 person-years), we identified 2497 cataract extraction cases. The multivariable hazard ratio (HR) for vitamin C supplement users compared with that for nonusers was 1.25 (95% CI: 1.05, 1.50). The HR for the duration of >10 y of use before baseline was 1.46 (95% CI: 0.93, 2.31). The HR for the use of multivitamins containing vitamin C was 1.09 (95% CI: 0.94, 1.25). Among women aged > or = 65 y, vitamin C supplement use increased the risk of cataract by 38% (95% CI: 12%, 69%). Vitamin C use among hormone replacement therapy users compared with that among nonusers of supplements or of hormone replacement therapy was associated with a 56% increased risk of cataract (95% CI: 20%, 102%). Vitamin C use among corticosteroid users compared with that among nonusers of supplements and corticosteroids was associated with an HR of 1.97 (95% CI: 1.35, 2.88).

    CONCLUSION: Our results indicate that the use of vitamin C supplements may be associated with higher risk of age-related cataract among women.

  • 13. Resic-Lindehammer, Sabina
    et al.
    Larsson, K.
    Örtqvist, E.
    Carlsson, A.
    Cederwall, E.
    Cilio, C. M.
    Ivarsson, S.-A.
    Jönsson, B. A.
    Larsson, H. E.
    Lynch, K.
    Neiderud, J.
    Nilsson, A.
    Sjöblad, S.
    Lernmark, Å.
    Aili, M
    Bååth, L. E.
    Carlsson, E.
    Edenwall, H.
    Forsander, G.
    Granstro, B. W.
    Gustavsson, I.
    Hanås, R.
    Hellenberg, L.
    Hellgren, H.
    Holmberg, E.
    Hörnell, H.
    Ivarsson, Sten-A.
    Johansson, C.
    Jonsell, G.
    Kockum, K.
    Lindblad, Birgitta
    Lindh, A.
    Ludvigsson, Jonas F
    Myrdal, U.
    Neiderud, J.
    Segnestam, K.
    Sjöblad, S.
    Skogsberg, L.
    Strömberg, L.
    Ståhle, U.
    Thalme, B.
    Tullus, K.
    Tuvemo, T.
    Wallensteen, M.
    Westphal, O.
    Åman, Jan
    Örebro University, School of Health and Medical Sciences.
    Temporal trends of HLA genotype frequencies of type 1 diabetes patients in Sweden from 1986 to 2005 suggest altered risk2008In: Acta Diabetologica, ISSN 0940-5429, E-ISSN 1432-5233, Vol. 45, no 4, p. 231-235Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare the frequency of human leukocyte antigen (HLA) genotypes in 1-18-year-old patients with type 1 diabetes newly diagnosed in 1986-1987 (n = 430), 1996-2000 (n = 342) and in 2003-2005 (n = 171). We tested the hypothesis that the HLA DQ genotype distribution changes over time. Swedish type 1 diabetes patients and controls were typed for HLA using polymerase chain reaction amplification and allele specific probes for DQ A1* and B1* alleles. The most common type 1 diabetes HLA DQA1*-B1*genotype 0501-0201/0301-0302 was 36% (153/430) in 1986-1987 and 37% (127/342) in 1996-2000, but decreased to 19% (33/171) in 2003-2005 (P \ 0.0001). The 0501-0201/0501-0201 genotype increased from 1% in 1986-1987 to 7% in 1996-2000 (P = 0.0047) and to 5% in 2003-2005 (P > 0.05). This study in 1-18-year-old Swedish type 1 diabetes patients supports the notion that there is a temporal change in HLA risk.

  • 14.
    Sagerfors, Susanna
    et al.
    Örebro University, School of Medical Sciences. Ophthalmology, Örebro University Hospital, Örebro, Sweden.
    Lindblad, Birgitta Ejdervik
    Ophthalmology, Örebro University Hospital, Örebro, Sweden.
    Söderquist, Bo
    Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Infectious keratitis: Isolated microbes and their antibiotic susceptibility pattern during 11 years in Region Örebro County, Sweden2018In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 59, no 9, article id 3678Article in journal (Refereed)
  • 15.
    Selin, Jinjin Z
    et al.
    Division of Nutritional Epidemiology, Institute of Environment al Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lindblad, Birgitta Ejdervik
    Örebro University, School of Medical Sciences. Örebro University Hospital. Division of Nutritional Epidemiology, Institute of Environment al Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Bottai, Matteo
    Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Morgenstern, Ralf
    Division of Biochemical Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wolk, Alicja
    Division of Nutritional Epidemiology, Institute of Environment al Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    High-dose B-vitamin supplements and risk for age-related cataract: a population-based prospective study of men and women2017In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 118, no 2, p. 154-160Article in journal (Refereed)
    Abstract [en]

    Previous studies that have investigated the association between B-vitamin supplement use and risk for cataract yield conflicting results. The aim of this study was to examine the association between use of high-dose B-vitamin supplements (approximately 10 times recommended daily intake) and risk for age-related cataract in a population-based prospective study of 13 757 women from the Swedish Mammography Cohort and 22 823 men from the Cohort of Swedish Men. Dietary supplement use and potential confounders were assessed using a questionnaire at baseline. Information on cataract diagnosis and extraction was obtained through linkage to registers. During the follow-up period between January 1998 and December 2011, we identified 8395 cataract cases (3851 for women and 4544 for men). The use of B vitamins plus other supplements and B vitamins only was associated with 9 % (95 % CI 2, 17) and 27 % (95 % CI 12, 43) increased risk for cataract, respectively. The hazard ratios for use of B vitamins only and risk for cataract stratified by different age groups were as follows: <60 years: 1·88 (95 % CI 1·47, 2·39); 60-69 years: 1·21 (95 % CI 0·96, 1·53); and ≥70 years: 1·09 (95 % CI 0·91, 1·31) (P interaction=0·002). Our results suggest that the use of high-dose B-vitamin supplements was associated with an increased risk for cataract. This association might be confined to younger participants.

  • 16.
    Selin, Jinjin Zheng
    et al.
    Inst Environm Med, Div Nutr Epidemiol, Karolinska Inst, Stockholm, Sweden.
    Lindblad, Birgitta Ejdervik
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
    Rautiainen, Susanne
    Inst Environm Med, Div Nutr Epidemiol, Karolinska Inst, Stockholm, Sweden.
    Michaelsson, Karl
    Dept Surg Sci, Sect Orthopaed, Uppsala Univ, Uppsala, Sweden.
    Morgenstern, Ralf
    Inst Environm Med, Div Biochem Toxicol, Karolinska Inst, Stockholm, Sweden.
    Bottai, Matteo
    Inst Environm Med, Div Biostat, Karolinska Inst, Stockholm, Sweden.
    Basu, Samar
    Fac Med, Dept Publ Hlth & Caring Sci, Uppsala Univ, Uppsala, Sweden; Ctr Excellence Inflammat, Univ Uppsala Hosp, Uppsala, Sweden; Lab Biochem Mol Biol & Nutr, Univ Auvergne, Clermont Ferrand, France.
    Wolk, Alicja
    Inst Environm Med, Div Nutr Epidemiol, Karolinska Inst, Stockholm, Sweden.
    Are increased levels of systemic oxidative stress and inflammation associated with age-related cataract?2014In: Antioxidants and Redox Signaling, ISSN 1523-0864, E-ISSN 1557-7716, Vol. 21, no 5, p. 700-704Article in journal (Refereed)
    Abstract [en]

    Oxidative stress and inflammation may be involved in the etiology of age-related cataract. This study is the first to investigate the association between urinary levels of 8-iso-prostaglandin F-2 alpha (PGF(2 alpha); as a biomarker for systemic oxidative stress in vivo) and 15-keto-dihydro-PGF(2 alpha) (as a biomarker for systemic inflammation in vivo) and risk of age-related cataract. We observed in a nested case-control study, including 258 women with incident cataract diagnosis and/or cataract extraction and 258 women without cataract, matched on age and date of urine sample collection that, women with higher levels of urinary 8-iso-PGF(2 alpha) as compared with lower levels had an increased risk of age-related cataract. There was no difference in 15-keto-dihydro-PGF(2 alpha) levels between cases and controls. Our observations lead to the hypothesis that higher systemic oxidative stress increases the risk of developing age-related cataract.

  • 17.
    Selin, Jinjin Zheng
    et al.
    Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Orsini, Nicola
    Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Lindblad, Birgitta Ejdervik
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden .
    Wolk, Alicja
    Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Long-term physical activity and risk of age-related cataract: a population-based prospective study of male and female cohorts2015In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 122, no 2, p. 274-280Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the association of total and specific types of physical activity, including walking or bicycling, exercising, work or occupational activity, home or housework, and leisure time inactivity with the risk of age-related cataract in women and men.

    Design: Population-based prospective cohort study.

    Participants: A total of 52 660 participants (23 853 women and 28 807 men) 45 to 83 years of age from the Swedish Mammography Cohort and the Cohort of Swedish Men.

    Methods: Physical activity was assessed using a self-administered questionnaire at baseline. Cataract diagnosis and extraction were identified through linkage to registers.

    Main Outcome Measures: Incident age-related cataract diagnosis and cataract extraction.

    Results: During a mean 12.1 years of follow-up (between January 1, 1998, and December 31, 2011; 634 631 person-years), 11 580 incident age-related cataract cases were identified. After adjusting for potential con-founders, the highest quartile of total physical activity was statistically significantly associated with 13% decreased risk of cataract compared with the lowest (hazard ratio [HR], 0.87; 95% confidence interval [CI], 0.82-0.92). Walking or bicycling (>60 minutes/day vs. hardly ever; HR, 0.88; 95% CI, 0.82-0.95) and work or occupational activity (heavy manual labor vs. mostly sitting; HR, 0.84; 95% CI, 0.78-0.91) also were associated with decreased risk of cataract. Exercise training and home or housework were not associated with cataract risk. Leisure time inactivity was associated with increased risk of cataract (>6 vs. <1 hours/day; HR, 1.27; 95% CI, 1.07-1.50). The HR for high long-term total physical activity compared with low levels both at 30 years of age and at baseline was 0.76 (95% CI, 0.69-0.85).

    Conclusions: Our findings indicate that high total physical activity, especially in the long term, and such specific types of physical activity as walking or bicycling and work or occupational activity, may be associated with decreased risk of age-related cataract. Conversely, high inactivity levels may be associated with increased risk of cataract.

  • 18.
    Selin, Jinjin Zheng
    et al.
    Division of Nut ritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Rautiainen, Susanne
    Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston MA, USA.
    Ejdervik, Birgitta Lindblad
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
    Morgenstern, Ralf
    Division of Biochemical Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wolk, Alicja
    Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    High-Dose Supplements of Vitamins C and E, Low-Dose Multivitamins, and the Risk of Age-related Cataract: A Population-based Prospective Cohort Study of Men2013In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 177, no 6, p. 548-555Article in journal (Refereed)
    Abstract [en]

    We examined the associations of high-dose supplements of vitamins C and E and low-dose multivitamins with the risk of age-related cataract among 31,120 Swedish men, aged 45-79 years, in a population-based prospective cohort. Dietary supplement use was assessed from a questionnaire at baseline in 1998. During follow-up (January 1998 December 2006), 2,963 incident age-related cataract cases were identified. The multivariable-adjusted hazard ratio for men using vitamin C supplements only was 1.21(95% confidence interval (Cl): 1.04, 1.41) in a comparison with that of non supplement users. The hazard ratio for long-term vitamin C users (>= 10 years before baseline) was 1.36 (95% Cl: 1.02, 1.81). The risk of cataract with vitamin C use was stronger among older men (>65 years) (hazard ratio = 1.92, 95% Cl: 1.41, 2.60) and corticosteroid users (hazard ratio = 2.11, 95% Cl: 1.48, 3.02). The hazard ratio for vitamin E use only was 1.59 (95% Cl: 1.12, 2.26). Use of multivitamins only or multiple supplements in addition to vitamin C or E was not associated with cataract risk. These results suggest that the use of high-dose (but not low-dose) single vitamin C or E supplements may increase the risk of age-related cataract. The risk may be even higher among older men, corticosteroid users, and long-term users.

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