June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Relationship between obesity defined using body mass index and objective body fat measures with visual impairment: Findings from the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study
Author Affiliations & Notes
  • Preeti Gupta
    Singapore Eye Research Institute, Singapore, Singapore
    Duke-NUS Medical School, Singapore, Singapore, Singapore
  • Aurora WD Chan
    Singapore Eye Research Institute, Singapore, Singapore
  • Ryan EK Man
    Singapore Eye Research Institute, Singapore, Singapore
    Duke-NUS Medical School, Singapore, Singapore, Singapore
  • Eva Fenwick
    Singapore Eye Research Institute, Singapore, Singapore
    Duke-NUS Medical School, Singapore, Singapore, Singapore
  • Ecosse Luc Lamoureux
    Singapore Eye Research Institute, Singapore, Singapore
    Duke-NUS Medical School, Singapore, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Preeti Gupta None; Aurora Chan None; Ryan Man None; Eva Fenwick None; Ecosse Lamoureux None
  • Footnotes
    Support  NMRC/CSA-SI/0009/2016
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4224. doi:
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      Preeti Gupta, Aurora WD Chan, Ryan EK Man, Eva Fenwick, Ecosse Luc Lamoureux; Relationship between obesity defined using body mass index and objective body fat measures with visual impairment: Findings from the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4224.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The relationship between obesity and vision is equivocal, possibly related to the obesity paradox and/or the use of body mass index (BMI) as an obesity measure which has been shown to correlate poorly with objective body fat mass (BFM) measures. To better clarify this relationship, we evaluated the association of BMI and BFM-defined total (total % body fat) and visceral (visceral fat area [VFA]) obesity with vision impairment (VI) severity using data from PIONEER. We hypothesize that obesity is associated with a reduced likelihood of having VI across the severity spectrum, although differential relationships between BMI-assessed and BFM-measured obesity with VI severity, may be evident.

Methods : PIONEER participants’ (median [IQR] age: 72 [14 years]; 54.5% female) BFM parameters were assessed using dual-energy X-ray absorptiometry (DXA; Hologic Inc.). Based on Asian cut-offs, obesity was defined as BMI ≥25kg/m2; total % body fat >33% (men), >43% (women); and VFA ≥100cm2. VI was categorized using presenting binocular LogMAR VI into mild (≥0.3 to <0.5) and moderate-severe (≥0.5). Multivariable linear and multinomial logistic regression models evaluated the associations between BMI and BFM-defined obesity and VI severity outcomes, adjusted for traditional confounders.

Results : Of the 2177 participants, 1061 (48.7%), 1158 (53.2%), and 1684 (77.4%) had BMI, total, and visceral obesity, respectively. Of the 354 (16.3%) with binocular VI, 225 (63.6%) were mild and 129 (36.4%) were moderate-severe. Both total and visceral obesity (but not BMI) were independently associated with a significant one-line improvement in binocular VA (β coefficient: -0.27 [total] and -0.30 [visceral]). Furthermore, for total and visceral obesity, inverse dose-response relationships were observed on VI severity (Prevalence Rate Ratio (PRR): 1.00 for none; range 0.90-0.92 [mild]; range 0.62-0.63 [moderate-severe]).

Conclusions : Greater total and visceral obesity measures, but not BMI, appear to confer a protective effect on VI as these were independently associated with better VA and lower VI severity. Our findings suggest that objectively-assessed obesity may be a better clinical indicator of visual health than BMI-defined obesity.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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