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Ching-Yu Cheng, Yih Chung Tham, Lingam Vijaya, Ningli Wang, Chenwei Pan, Rohit Chandramohan Khanna, Suman Thapa, Mingguang He, Rupert R A Bourne, Jost B Jonas; Are Diabetes, Hypertension, and Obesity Associated with Primary Open Angle Glaucoma? A meta-analysis of 13 population-based studies in Asia. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3712.
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Diabetes, hypertension and obesity have been postulated to be associated with primary open angle glaucoma (POAG). Nevertheless, previous studies reported largely conflicting findings. In this meta-analysis, we aimed to comprehensively examine the associations between these systemic conditions with POAG in Asians.
The Asian Eye Epidemiology Consortium is a network of population-based studies across Asia, including studies from China, India, Nepal, Singapore and Thailand. The diagnosis of POAG in all studies was defined based on the standardized International Society of Geographical and Epidemiological Ophthalmology criteria. Each study performed multivariable logistic regression, following a standardized analysis protocol with diabetes, hypertension and obesity as exposures and POAG as outcome, adjusting for age, gender, diabetes, hypertension and body mass index (BMI) accordingly. The effect estimates (odds ratio [OR]) of diabetes, hypertension and obesity from each study were then pooled using random effects meta-analysis.
A total of 45,557 individuals from 13 population-based studies were included in this meta-analysis. Of them, the mean age was 58.2 ± 10.4 years, 25,091 (55.1%) were females, and 1,038 (2.3%) had POAG. Individuals with diabetes were 1.25 times (95% confident interval [CI], 1.03 to 1.50; P = 0.019) likely to have POAG, compared to those without, after adjusting for age, gender, hypertension and BMI. This association was significantly only among individuals residing in urban and mixed areas (OR = 1.28; 95% CI; 1.04 to 1.57; P = 0.017), but not in rural area (OR = 1.10; 95% CI; 0.66 to 1.82; P = 0.725). On the other hand, hypertension (OR = 1.13; 95% CI, 0.91 to 1.42; P = 0.275) and obesity (OR = 1.08; P = 0.734, compared to those with normal BMI), were not significantly associated with POAG.
Among Asians, diabetes is associated with greater risk of POAG, and this effect is more prominently observed among individuals residing in urban area. These findings provide further concrete evidence on the role of diabetes on risk of POAG. We find no evidence of association between hypertension, obesity and POAG, which findings are different from those observed in the populations of European descent.
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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