Serum Lipid Abnormalities and Age-Related Cataract: A Hospital-Based Case-Control Study in North India

Dyslipidaemia may contribute to age-related cataract through altered lens membrane homeostasis, oxidative stress and lipid peroxidation, but clinical evidence remains inconsistent.

To compare serum lipid profiles in adults with and without age-related cataract and quantify the independent associations of specific lipid abnormalities with cataract.

This hospital-based case-control study included 300 adults aged 50 years or older at a tertiary care centre in Kanpur, India, from April 2024 to October 2025. Cases were 150 patients with age-related cataract, and controls were 150 participants without cataract. Patients with diabetes, secondary cataract or lipid-lowering therapy were excluded. Fasting total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured by enzymatic colourimetry. Separate multivariable logistic regression models adjusted each lipid abnormality for age, sex, education, occupation, smoking, alcohol use and socioeconomic status.

Cases were older than controls (63.07 ± 6.14 vs 60.70 ± 6.67 years; p = 0.002). Compared with controls, cases had higher total cholesterol (209.62 ± 33.23 vs 183.10 ± 28.08 mg/dL), triglycerides (169.42 ± 34.47 vs 146.65 ± 27.12 mg/dL), LDL-C (138.69 ± 30.45 vs 119.17 ± 21.27 mg/dL) and VLDL-C (33.89 ± 6.89 vs 29.33 ± 5.42 mg/dL), and lower HDL-C (39.49 ± 5.90 vs 45.95 ± 6.75 mg/dL; all p < 0.001). Adjusted odds of cataract were higher with low HDL-C (adjusted odds ratio {aOR} 3.91, 95% confidence interval {CI} 2.22-6.89), high LDL-C (aOR 3.06, 95% CI 1.86-5.04), high VLDL-C (aOR 3.03, 95% CI 1.84-5.00), high triglycerides (aOR 2.69, 95% CI 1.64-4.43) and high total cholesterol (aOR 2.49, 95% CI 1.54-4.05). Lipid distributions did not differ significantly across the 15 recorded cataract morphology categories.

Dyslipidaemia, particularly low HDL-C and elevated atherogenic lipids, was independently associated with age-related cataract in this hospital population. These findings identify a clinically relevant metabolic correlate but do not establish causality. Prospective population-based studies should determine whether lipid abnormalities predict cataract onset or progression.