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P. Newman-Casey, N. Talwar, B. Nan, D. C. Musch, J. D. Stein; The Relationship Between Components of Metabolic Syndrome and Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3974.
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To determine whether an association exists between the various components of metabolic syndrome [diabetes mellitus (DM), arterial hypertension (HTN), hyperlipidemia, and obesity] and open-angle glaucoma (OAG) in a large, diverse group of individuals throughout the United States.
All beneficiaries age ≥40 years continuously enrolled in a large managed care network who had ≥1 visit to an eye care provider were identified from 2001-2007. ICD-9 billing codes were used to identify individuals with OAG and those with components of metabolic syndrome. Cox regression was used to determine the hazard of developing OAG in patients with components or combinations of components of metabolic syndrome, with adjustment for sociodemographic factors, systemic medical conditions, and other ocular diseases.
Of the 2,182,315 enrollees who met inclusion criteria, 54,558 (2.5%) had OAG. After adjustment for confounding factors, those HTN (HR = 1.35; 95% CI: 1.21-1.50) or DM (HR = 1.17; 95% CI: 1.13-1.22) alone, or in combination, (HR = 1.48; 95% CI: 1.39-1.58) had an increased hazard of developing OAG relative to persons with neither of these conditions. The presence of hyperlipidemia in combination with HTN (HR = 1.13; 95% CI: 1.05-1.21) or with DM (HR = 1.09; 95% CI: 1.05-1.12) showed HRs of lesser magnitude. By contrast, persons with hyperlipidemia alone had a 5% decreased hazard of OAG (HR = 0.95; 95% CI: 0.91-0.98) compared with persons who had no components of metabolic syndrome.
In this large, diverse sample, the presence of HTN, DM, and obesity increased the hazard of developing OAG, while hyperlipidemia decreased the hazard of developing OAG. Given the increasing prevalence of metabolic disorders in the US, this study furthers our understanding of risk factors associated with OAG and helps identify persons who may benefit from screening for this condition. Determining whether hyperlipidemia or the medications used to treat this condition reduce the hazard of OAG may lead to novel OAG treatment strategies.
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