Abstract
Purpose :
Glaucoma is a leading cause of irreparable vision loss worldwide. Identifying modifiable risk factors beyond intraocular pressure is beneficial for improved patient outcomes. Obesity has been postulated as a risk factor for glaucoma, but current literature about this relationship is conflicting. This study examined the association between body mass index (BMI), central obesity (CO), and metabolic syndrome (MetS) and glaucoma prevalence using the National Institute of Health’s “All of Us” (AoU) database.
Methods :
Participants age 40 years and older in AoU with Electronic Health Record (EHR) and BMI data were included. The primary exposures included BMI, CO, MetS, and MetS Severity Score (MSSS), which is based on confirmatory factor analysis of components of MetS (blood pressure, triglyceride, HDL, CO, and blood glucose). Glaucoma prevalence was defined by EHR data. Multivariable logistic regression was used to examine the relationship between each exposure and glaucoma, adjusting for age, sex, race, education level, income level, for all analyses and additionally mean arterial pressure, hyperlipidemia, and diabetes in the analyses of BMI and CO.
Results :
Of the 156,476 included participants, 8,643 (5.52%) had glaucoma. Those who were overweight (adjusted odds ratio [aOR]: 0.79, 95% confidence interval [CI]: 0.74-0.85) or obese (aOR: 0.77, 95% CI:0.72-0.83) based on BMI, or had central obesity (aOR: 0.86, 95% CI:0.81-0.91) had a lower risk of having glaucoma compared to those without each condition. However, those with MetS (aOR:1.56, 95% CI:1.48-1.64), and high MSSS (aOR:1.2, 95% CI: 1.18-1.22) had higher odds of having glaucoma compared to those without MetS and with lower MSSS, respectively.
Conclusions :
In the AoU database, those who were overweight, obese, or had CO had a decreased likelihood of a diagnosis of glaucoma. In contrast, those with MetS or a high MSSS had a higher likelihood of a diagnosis of glaucoma. These findings suggest that metabolic syndrome, rather than obesity alone, may be a risk factor for glaucoma. Future research examining the role of MetS in the pathogenesis of glaucoma would be beneficial to identify potential strategies for improved disease management.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.