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Jae H Kang, Janey L Wiggs, Louis R Pasquale; Sex hormone levels and risk of primary open-angle glaucoma in postmenopausal women. Invest. Ophthalmol. Vis. Sci. 2016;57(12):No Pagination Specified.
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To evaluate pre-diagnostic sex hormone levels in postmenopausal women in relation to primary open-angle glaucoma (POAG).
Blood samples were collected in 1989-1990 in the Nurses’ Health Study, and medical-record confirmed incident POAG cases were identified (252 cases and 1815 controls; date of diagnosis from after blood draw to 2012) among postmenopausal women not on postmenopausal hormone therapy at blood draw. Plasma concentrations of estrone sulfate, estradiol and testosterone were assessed. Multivariable logistic regression was used to evaluate tertiles of biomarker levels, adjusting for various potential confounders including age, race, family history of glaucoma, cigarette smoking, hypertension, diabetes and body mass index. The primary outcome was POAG; in secondary analyses, we evaluated subtypes defined by maximum intraocular pressure (IOP) at diagnosis.
The median levels of sex hormones among controls were 23.9 pg/mL for estrone, 5.7 pg/mL for estradiol and 18.9 ng/dL for testosterone. We observed no associations with estrone (p for trend [p-trend]=0.25) or estradiol (p-trend=0.48) and POAG. For testosterone, compared to the lowest tertile (median=18.5 ng/dL), the highest tertile (median= 30.7 ng/dL) showed a significant increased risk of POAG (multivariable odds ratio [OR]=1.76, 95% CI=1.18-2.62; p-trend=0.01). Also, the adverse association with testosterone was stronger with high tension glaucoma (maximum IOP > 21 mmHg at diagnosis) with highest versus lowest tertile comparison of OR= 2.10 (95% CI=1.24-3.56; p-trend=0.01) versus OR= 1.20 (95%CI=0.62-2.34; p-trend=0.58) for normal tension glaucoma (maximum IOP ≤ 21 mmHg at diagnosis).
Higher testosterone levels in postmenopausal women were adversely associated with POAG, particularly for high tension glaucoma.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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