Deleterious Impact of Non-Diabetic Cataract Surgery on the Values of Biomarkers of Oxidative Stress and Metabolic Syndrome in Kinshasa

Author(s): Christian Mwembo Nkolomonyi, Moise Mvitu Muaka, Edith Mboyo Efeko, Ndimbani Malosa Franck, Nganga Nkanga Mireille Solange, Héritier Mawalala Malengele, Christian Kisoka Lusunsi, Benjamin Longo-Mbenza.

Study Background and Purpose: Cataract is considered a structural marker of systemic metabolic disorders. Its association with metabolic syndrome (MS) and oxidative stress has only been well established in diabetic patients. The objective of the present study was to evaluate the impact of non-diabetic cataract surgery on biomarkers of SM and oxidative stress according to the pre-post operative phases.

Material and Methods: This was a mixed study, a consecutive series combining an intervention (quasi-experimental study before and after cataract surgery), a documentary study (patient file), a comparative and evaluative approach involving 163 patients over the age of 40, during a period from September 1 to December 31, 2022 at the MASINA Ophthalmological Center. Nominal variables were presented as frequencies, while quantitative variables as means ± SD. Pearson's Chi-Square test and Yates' Chi-Square test were used to compare the proportions between two groups. The threshold for statistical significance was set at any value of P<0.05.

Results: Of a total of 163 patients, 60.1% (n=98) were men versus 39.9% (n=65) women. Nearly 81.6% (n=133) of the patients were of an advanced age-Senior ≥ 60 years old. Cataract surgery very significantly induced a deleterious impact on the rest of the components of the metabolic syndrome/insulin resistance-oxidative stress-atherosclerosis: the increase in mean BMI values (23.7 ± 4.1 vs 32.8 ± 5.4; P<0 .0001), CT (124.9±46.5 vs 279.6±88.7 mg/ dL ; P<0.0001), LDL (94.5±34.1 vs 191.4±65.9 mg/ dL ; P<0.0001), TG (90.7± 45.9 vs 200.6±73.9 mg/ dL ; P<0.0001) and glycaemia (92.7±8.1 vs 101.8±10.6 mg/ dL ; P<0.0001) in the postoperative phase being higher than those of the before surgery while the mean values of PAS, PAD, HDL and Albumin (P<0.0001) of the postoperative phase were lower than those of the phase before cataract surgery. Biomarkers of insulin resistance and atherogenicity were very significantly higher after cataract surgery: TYG (8.2±0.5 vs 9.2±0.4; P<0.0001), CT/HDL ratio (2.6±1.1 vs 16.9±28 ; P<0.0001), LDL/HDL ratio (1.93±0.8 vs 11.5±19.8; P<0.0001), TG/HDL ratio (1.8±0.9 vs 11.7±25.4; P<0.0001), Non HDL (74.9±48.3 vs 247.4 ±102.4mg/ dL ; P<0.0001).

Conclusion: The present study confirmed that cataract is a structural marker of systemic disorders and a state of pre-hypertension, pre-diabetes, preatherosclerosis and oxidative stress in Bantu patients. A multidisciplinary postoperative follow-up is necessary.