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Associations between physical activity and cataract treated surgically in patients with diabetes: findings from the 45 and Up Study
  1. Changfan Wu1,2,
  2. Xiaotong Han2,3,
  3. Xixi Yan2,4,
  4. Xianwen Shang2,
  5. Lei Zhang2,5,6,7,
  6. Mingguang He2,3
  1. 1 Department of Ophthalmology, Yijishan Hospital Wannan Medical College, Wuhu, China
  2. 2 Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
  3. 3 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  4. 4 Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, China
  5. 5 Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
  6. 6 Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
  7. 7 Research Centre for Public Health, Tsinghua University, Beijing, China
  1. Correspondence to Dr Mingguang He, Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia; mingguanghe{at}gmail.com

Abstract

Aim To investigate the association between physical activity (PA) and incidence of cataract surgery among patients with diabetes.

Methods We obtained data from all diabetic subjects aged 45-65 years from the baseline of the prospective 45 and Up Study from 2006 to 2009 and linked to the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) until 2016. Diabetes was defined as self-reported on questionnaire or diabetes medication history based on PBS. Cataract surgery was determined based on the MBS, and metabolic equivalent intensity level number of PA sessions per week was used to assess PA. Cox regression was used to assess the association between baseline PA and cataract surgery during the follow-up.

Results A total of 9113 diabetic participants in the 45 and Up Study were included in the current analysis with a mean age of 57.3±5.2 years (43.6% female). During a mean follow-up of 8.8 years, 950 participants (10.4% of baseline) received cataract surgery with a corresponding incidence of 12.4/1000 person-years. Cox regression analysis showed that people with less PA (p=0.01), older age (p<0.001), female gender (p<0.001), higher educational level (p<0.001) and longer diabetic duration (p<0.001) had significantly higher cataract surgery risk. Participants with a PA level of ≥14 sessions per week had 19% decreased risk of cataract surgery compared to those with <5 sessions per week. Stratification analysis showed that participants with more obesity (p value for interaction=0.03), not taking insulin (p value for interaction=0.01) and without cardiovascular disease (p value for interaction=0.008) could benefit significantly more from PA in reducing their cataract surgery risk.

Conclusions More vigorous PA was independently associated with a reduced risk of cataract surgery in working-aged patients with diabetes.

  • treatment surgery
  • epidemiology
  • public health

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Footnotes

  • CW and XH contributed equally.

  • Contributors Wu CF, Conception of the work, data acquisition, data interpretation and draft the manuscript.

    Han XT, Conception of the work, draft the manuscript, major manuscript revision and Data

    interpretation. Yan XX, data acquisition, data interpretation and revision. Shang XW, analysis, data collection and revision. Zhang L, conception of the work, revision and final approval of the version to be published. He MG, conception of the work, revision and final approval of the version to be published. The sponsor or funding organization had no role in the design or conduct of this research.

  • Funding Professor MH receives support from the University of Melbourne at research Accelerator Program and the CERA Foundation. The Centre for Eye Research Australia (CERA) receives operational infrastructure support from the Victorian State Government. The specific project is funded by Australia China Research Accelerator Program at CERA. Professor MH is also supported by the Fundamental Research Funds of the State Key Laboratory in Ophthalmology, National Natural Science Foundation of China (81420108008). The sponsor or funding organization had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval University of NSW Human Research Ethics Committee; Royal Victorian Eye and Ear Hospital Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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