Abstract
Purpose :
Sedentary behavior (SB) is a modifiable risk factor for several adverse health outcomes, such as cardiovascular disease and all-cause mortality, but its association with dry eye disease (DED) remains unclear. SB may increase low-grade systemic inflammation, which can contribute to DED, making it important to understand DED’s relationship with this potentially modifiable risk factor. This large population-based, cross-sectional study aimed to test the hypothesis that SB is tied to an increased risk of DED.
Methods :
We included participants from the population-based Lifelines cohort (n=48,418, 58% female, mean age = 51.4 years). DED was assessed using the Women’s Health Study (WHS) dry eye questionnaire, and SB with the Marshall Sitting Questionnaire. We analyzed the relationship between DED and SB using logistic regressions, corrected for age, sex, BMI, smoking status, demographics, and 48 comorbidities. Additionally, we corrected for time of moderate to vigorous physical activity (MVPA) and stratified by WHO’s recommendations of MVPA (<150 vs. ≥150 min/week) in analyses above. Finally, to investigate the impact of SB independent of computer screen exposure, the analyses were repeated for sitting time excluding time spent sitting behind a computer at home or at the office.
Results :
In total, 9.1% of the population had WHS-defined DED. Greater SB was associated with an increased risk of dry eye (odds ratio (OR) 1.015 per hour/day, 95%CI 1.005-1.024, P=0.004). This result did not change after MVPA adjustment. Interestingly, the association between SB and WHS-defined DED was only significant for those with <150 min of MVPA/week (OR 1.022, 95%CI 1.002-1.042, P=0.027, n=11,783), and not in those with ≥150 min/week (OR 1.011, 95%CI 0.999-1.023, P=0.076, n=32,353). Lastly, when excluding time spent sitting during computer use, the relationship between SB and DED was substantially attenuated, and no longer significant (OR 1.009, 95%CI 0.996-1.023, P=0.19).
Conclusions :
Supporting the hypothesis, we found that greater SB was tied to an increased risk of DED. However, sufficient physical activity appeared to mitigate the risk. Finally, as there was no association when only analyzing the subsample with <2 hours of daily computer use, future studies should investigate the impact of sitting time with and without computer use separately.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.