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Javier Moreno-Montanes, Alejandro Fernández-Montero, Alfredo Gea, Estefania Toledo, Laura Moreno-Galarraga, Belen Alfonso-Bartolozzi, Miguel Angel Martinez; Variations in body mass index and the incidence of glaucoma: the SUN study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3713.
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© ARVO (1962-2015); The Authors (2016-present)
Controversy exists regarding the relationship between glaucoma and Body Mass Index (BMI). The goal of this study is to determine the relationship between glaucoma incidence and basal BMI or BMI changes in a cohort of participants taken from a dataset called the Seguimiento Universidad de Navarra (SUN study).
. In this prospective and dynamic cohort, 16 827 participants initially free of glaucoma were included. The total follow-up period of the SUN study spans more than 14 years (divided in 7 periods of 2 years each). Participants answered a questionnaire biennially, resulting in 7 possible periods of biennial follow-up. Each period was analysed using repeated measurements. Information on BMI and glaucoma was assessed in each follow up questionnaire, and changes in BMI were always confirmed to be previous to the reported date of glaucoma within each of the seven follow-up periods. To study the change in BMI, we stratified into 3 categories: Participants earning more than 3 BMI units, participants losing more than 3 BMI units, and participants whose weight variation was between +3 or -3 BMI units. This last category was used as the reference category. The number of person-years was 43 551. The outcome was the incidence of self-reported glaucoma. The statistical analysis was performed using a multivariable adjusted Hazard-Ratio (HR) and a 95% Confidence Interval (CI) across three categories, using a time-dependent Cox regression analysis multivariable model (STATA 12.0). The self-reported diagnosis of glaucoma was validated in a sub-sample.
During 14 years of follow-up, 187 new cases of glaucoma were identified. The incidence of glaucoma was not related to the basal BMI: obesity (BMI>30) [HR 1.05 (95% CI: 0.58-1.92); p=0.86] nor low BMI (BMI<18.5) [HR 0.63 (95% CI: 0.15-2.64); p=0.53]. Furthermore, a BMI increase of more than 3 units was not related to the new glaucoma cases [HR 0.77 (95% CI: 0.24-2.49); p=0.67]. In contrast, a BMI decrease of more than 3 units was found to be related to glaucoma incidence [HR 2.90 (95% CI: 1.33-6.34); p=0.008].
Our results suggest that the incidence of glaucoma is not related to the basal BMI or to an increase in BMI. However, the study found an association between a large decrease in BMI and new cases of glaucoma.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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