Association between inflammatory biomarkers and cataracts: validation from the NHANES database and clinical studies

Introduction Cataract-associated blindness has increasingly emerged as a major public health issue. Although inflammatory and nutritional status are well-established contributors to various systemic diseases, their associations with cataracts remain underexplored. This study leveraged the NHANES database to investigate the associations between inflammatory and nutritional biomarkers and cataract surgery history prevalence, with subsequent validation using hospital-based clinical data. Methods Participants with complete data from the 2005–2008 NHANES cycles were included. Baseline characteristics were first compared between groups. Multivariate logistic regression and restricted cubic spline (RCS) analyses were then employed to assess the associations between inflammation-nutrition indices and cataract surgery history prevalence. Subgroup analyses and interaction tests were conducted to evaluate consistency across diverse populations. Receiver operating characteristic (ROC) curve analysis determined the predictive utility for cataract surgery history prevalence. Sensitivity analyses were performed to bolster the robustness of the results. Finally, findings were validated using clinical cohort data. Results The study included 8,194 participants. After adjustment for pertinent confounders, log-transformed AISI (Ln-AISI), NAR (Ln-NAR), and MAR (Ln-MAR) exhibited a linear positive association with cataract surgery history prevalence. Subgroup analyses demonstrated no significant interactions in strata defined by age, gender, smoking status, alcohol consumption, hypertension, diabetes, and body mass index (all p -values for interaction 0.05). Two sensitivity analyses confirmed the robustness of these associations. ROC analysis revealed that Ln-MAR (AUC = 0.592) showed the strongest association with cataract surgery history prevalence among the three markers, although the discriminatory ability of all three indices remained modest. In the clinical cohort, the cataract group displayed elevated MAR and NAR levels but reduced ALI levels compared to the non-cataract group. Conclusion This study demonstrates positive correlations between MAR, NAR, and AISI with cataract surgery history prevalence, underscoring the intimate link between systemic inflammation, nutritional status, and cataract pathogenesis. Strategies aimed at mitigating systemic inflammation and optimizing nutritional balance may hold promise for cataract prevention.