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

Background: Dyslipidaemia may contribute to age-related cataract through altered lens membrane homeostasis, oxidative stress and lipid peroxidation, but clinical evidence remains inconsistent.Objective: To compare serum lipid profiles in adults with and without age-related cataract and quantify the independent associations of specific lipid abnormalities with cataract.Methods: 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 lipidlowering 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.Results: 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.Conclusion: 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.