Purpose
Studies examining the apolipoprotein E (
APOE
)
ε4
allele and glaucoma are inconsistent, which could be due to interactions with other factors. We examined the relationship between the
APOE ε4
allele and glaucoma and intraocular pressure in a large, population-based random sample and explored whether the
APOE ε4
allele interacted with systemic hypertension.
Methods
Data came from the Canadian Longitudinal Study on Aging, a population-based study that included 24,655 adults ages 45 to 85 years old in the European ancestry cohort.
APOE
genotypes were derived from single-nucleotide polymorphisms rs429358 and rs7412. Participants were asked about a prior diagnosis of glaucoma from a doctor. Corneal compensated intraocular pressure (IOP) was measured using the Reichart Ocular Response Analyzer.
Results
Having an
APOE ε4
allele was associated with a lower odds of glaucoma after adjusting for age, sex, IOP, and the top 10 population structure principal components (odds ratio [OR] = 0.83; 95% confidence interval [CI], 0.69-0.98;
P
= 0.033). A novel statistically significant interaction was found in that having an
APOE ε4
allele was only associated with glaucoma in those without systemic hypertension (OR = 0.62; 95% CI, 0.46-0.85) although it was not associated in those with it (OR = 0.97; 95% CI, 0.79-1.21) (interaction term
P
value = 0.017).
APOE ε4
was not associated with IOP (β = −0.01; 95% CI, −0.13 to 0.10)
.
Conclusions
Evidence increasingly points to the
APOE ε4
allele having protective benefits against glaucoma, but this association was limited to those without systemic hypertension. Further research is needed to understand the biological mechanisms for these findings and the treatment potential they hold.
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