A Longitudinal Study of Association between Adiposity Markers and Intraocular Pressure: The Kangbuk Samsung Health Study

Abstract

ImportanceIntraocular pressure (IOP) reduction or stabilization is the only proven method for glaucoma management. Identifying risk factors for IOP is crucial to understand the pathophysiology of glaucoma.ObjectiveTo examine the associations of change in body mass index (BMI), waist circumference, and percent fat mass with change in intraocular pressure (IOP) in a large sample of Korean adults.Design, setting and participantsCohort study of 274,064 young and middle age Korean adults with normal fundoscopic findings who attended annual or biennial health exams from January 1, 2002 to Feb 28, 2010 (577,981 screening visits).ExposuresBMI, waist circumference, and percent fat mass.Main Outcome Measure(s)At each visit, IOP was measured in both eyes with automated noncontact tonometers.ResultsIn multivariable-adjusted models, the average increase in IOP (95% confidence intervals) over time per interquartile increase in BMI (1.26 kg/m2), waist circumference (6.20 cm), and percent fat mass (3.40%) were 0.18 mmHg (0.17 to 0.19), 0.27 mmHg (0.26 to 0.29), and 0.10 mmHg (0.09 to 0.11), respectively (all P < 0.001). The association was stronger in men compared to women (P < 0.001) and it was only slightly attenuated after including diabetes and hypertension as potential mediators in the model.Conclusions and RelevanceIncreases in adiposity were significantly associated with an increase in IOP in a large cohort of Korean adults attending health screening visits, an association that was stronger for central obesity. Further research is needed to understand better the underlying mechanisms of this association, and to establish the role of weight gain in increasing IOP and the risk of glaucoma and its complications.

Ten‐year changes of intraocular pressure in adults: the Liwan Eye Study

“…4,5 Limited longitudinal studies have been conducted in East Asian populations, and these had furthermore presented conflicting results. 13 The Singapore Malay Eye Study reported a reduced IOP with normal aging in South East Asians. 11 In contrast, Nakano et al found a decrease in IOP over 10 years in a group of healthy Japanese male aircraft crew members.…”

“…Association between sex and IOP had been reported with inconsistent results. 13 Further research is needed to better understand the mechanisms between gender and IOP association. 8,35 The Kangbuk Samsung Health Study found females had a lower IOP compared to males and the yearly decrease in IOP was also smaller in females.…”

“…[10][11][12][13] Therefore more populationbased longitudinal studies are needed to investigate age-related IOP changes. In current literature, limited longitudinal studies of IOP in Asian populations existed with Nomura et al found an increasing trend in IOP with aging, while Nakano et al and two other longitudinal Korean studies reported a decreasing trend.…”

“…In current literature, limited longitudinal studies of IOP in Asian populations existed with Nomura et al found an increasing trend in IOP with aging, while Nakano et al and two other longitudinal Korean studies reported a decreasing trend. [10][11][12][13] Therefore more populationbased longitudinal studies are needed to investigate age-related IOP changes. China has the largest absolute number of glaucoma patients in the world, 14 and to the best of our knowledge, no conclusion had been reached from population-based studies concerning the longitudinal trend in IOP changes in China.…”

Metabolically Healthy Obesity and Development of Chronic Kidney Disease

“…We suggest that Chang and colleagues use their Kangbuk Samsung Health Study to assess whether the decline in the estimated GFR might be associated more strongly with baseline lean mass rather than adipose tissue. As the authors recently reported (3), their healthy-worker cohort also provided measurements of bioelectric impedance and waist circumference. Thus, baseline values can be calculated for the percentage of fat and fat-free mass and the waist–height ratio.…”