OBJECTIVE To compare body mass index with waist-to-hip ratio as correlates of age-related eye disease.
DESIGN Population-based cross-sectional study.
PARTICIPANTS Participants of the Beaver Dam Eye Study at 5-year follow-up examinations.
METHODS Body mass index was computed from weight and height, and waist-to-hip ratio was computed from measurements all done at the 5-year examination. Presence of ocular lesions was based on gradings of standard photographs of the retina and lens.
MAIN OUTCOME MEASURES Presence of early and late age-related maculopathy and nuclear, cortical, and posterior subcapsular cataracts.
RESULTS In women, early age-related maculopathy was significantly associated with both body mass index and waist-to-hip ratio. The relationship between waist-to-hip ratio and late age-related maculopathy was of borderline significance. When analyzed as continuous measures, waist-to-hip ratio was more strongly associated with nearly every outcome compared to body mass index. In men, there was little difference between body mass index and waist-to-hip ratio as correlates of age-related eye diseases. The reason for differences between men and women is not clear, but is unlikely to be due to current exposure to estrogen.
CONCLUSIONS In women in our analyses, waist-to-hip ratio is more strongly associated with age-related eye disease than is body mass index. When adiposity is considered as a risk factor itself, or as a confounder of risk factors for age-related ocular disease, waist-to-hip ratio may be the better measure to use in women.