Effect of hydrophilic and lipophilic statins on early onset cataract: A nationwide case-control study

Regul Toxicol Pharmacol. 2021 Aug:124:104970. doi: 10.1016/j.yrtph.2021.104970. Epub 2021 Jun 2.


Background: Statin is biologically plausible in cataract development, but inconclusive associations between statin and cataract are presented in human studies. Given most early onset cataract (EOC) occurs in regions with high cholesterol composition, we therefore aimed to assess the association between statin and EOC.

Methods: A population based case-control study was performed using the Taiwan National Health Insurance Research Database (NHIRD). The case involved patients aged 20-55 years with EOC. Controls were 1:1 matched by age, gender, year of index date, and propensity score estimated from comorbidities and comedications. Statin exposure, including intensity, properties and cumulative exposure one year before the index date were tracked. The odds ratios (ORs) of EOC associated with statin were estimated by conditional logistic regression.

Results: A total of 4213 cases and 4213 controls were included. Statins were associated with EOC (OR = 3.257, 95% CI 2.519-4.211). The ORs of cataract was positively associated with cumulative exposure. Subgroup analysis indicated that the ORs of cataract were significant both in lipophilic (OR = 3.485, 95% CI 2.606-4.659) and hydrophilic (OR = 3.241, 95% CI 1.975-5.321) statin users.

Conclusions: Statins were associated with an increased risk of cataract in young populations.

Keywords: Early onset cataract; Observational study; Statin.

MeSH terms

  • Adult
  • Age of Onset
  • Case-Control Studies
  • Cataract / chemically induced
  • Cataract / epidemiology*
  • Databases, Factual / statistics & numerical data
  • Female
  • Humans
  • Hydrophobic and Hydrophilic Interactions
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / chemistry
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Risk Assessment / statistics & numerical data
  • Risk Factors
  • Taiwan / epidemiology
  • Young Adult


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors