Abstract
Purpose :
Modifiable risk factor identification is important to potentially prevent, detect, and treat glaucoma. The associations between glaucoma and aspects of weight loss including exercise and nutrient intake are poorly understood. We examined associations between weight loss strategies and glaucoma in the 2005-2008 National Health and Nutrition Examination Survey (NHANES).
Methods :
This was a retrospective study using data from the 2005-2008 NHANES database. Adults reported weight loss strategies including amount and type of food intake, exercise, smoking, and health professional consult. Glaucoma was defined as 2+ abnormal points on visual fields and cup-to-disc ratio (CDR) or CDR asymmetry ≥97.5% of the NHANES population. Covariates included age, ethnicity, gender, blood pressure, and body mass index (BMI). Logistic regression modeling was used to examine associations between each type of weight loss strategy and glaucoma in the population, while adjusting for all covariates. Analyses were weighted using NHANES multistage sampling design.
Results :
In NHANES, 3,076,410/83,643,392 (3.7%) subjects had glaucoma. In 29,800,440 subjects attempting weight loss, those who exercised had a statistically significant increased likelihood of glaucoma (adjusted odds ratio [aOR]=2.6, 95% confidence interval (CI)=[1.0, 6.7], p=0.04). Similarly, non-prescription diet pill use and drinking water were associated with a higher likelihood of glaucoma (aOR=4.2 [1.1, 16.1], p=0.03) (aOR=2.1 [1.0, 4.6], p=0.05), respectively. A dietitian or health professional consult by subjects attempting weight loss was associated higher likelihood of glaucoma (aOR=7.7 [2.0, 29.1], p=0.003). The likelihood of glaucoma was 80% lower in subjects who ate less as a strategy for weight loss (aOR=0.2 [0.1, 0.4], p=0.004). In 9,207,553 subjects avoiding weight gain, eating less was associated with less risk.
Conclusions :
In adult NHANES participants attempting to lose weight, exercise, supplement use, drinking water, and dietitian consults were all associated with an increased likelihood of glaucoma when the analysis was controlled for age, ethnicity, gender, blood pressure, and BMI. The only weight loss strategy that was associated with decreased odds of glaucoma was eating less. Since this is a cross-sectional study, the role of weight loss strategies in the development or progression is unknown. Further research is needed.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.