Abstract
Purpose :
We sought to investigate the association between metabolic syndrome, metabolic health, and its components with incident primary open-angle glaucoma.
Methods :
We included participants from the UK Biobank without glaucoma at enrolment. The primary outcome was incident POAG. Incident events were recorded through self-report at UK Biobank assessment visits and diagnostic coding via linked hospital inpatient and primary care data. Cox regression was used to assess the relative hazard of metabolic syndrome and its components, including waist circumference, high-density lipoprotein cholesterol, triglycerides, glycated haemoglobin, systolic and diastolic blood pressure, body mass index, and diabetes.
Results :
The eligible cohort consisted of 497 211 participants. There were 2477 events of incident POAG over 5 873 201 person-years of follow-up, with a mean follow-up of 11.30 years. In a multivariable model including the individual components of metabolic syndrome, compared to a normal BMI of 24 kg/m2, higher BMI reduced the hazard of incident POAG. Metabolic syndrome (HR 1.14, CI 1.01-1.29) and a metabolically unhealthy state (HR 1.32, CI 1.14 - 1.53) were associated with an increased hazard of developing incident POAG. When metabolic health was stratified by obesity status, only those metabolically unhealthy and non-obese had a higher risk of incident POAG (HR 1. 24, CI 1.07-1.45).
Conclusions :
BMI appears to play a role in the relationship between metabolic health and incident glaucoma. The increased risk of glaucoma with metabolic syndrome and a metabolically unhealthy state was predominantly seen in those with lower BMI, whilst obesity may be protective in an otherwise metabolically healthy individual.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.