Association of serum uric acid levels with primary open‐angle glaucoma: a 5‐year case–control study

Li, Shengjie; Shao, Mingxi; Li, Danhui; Tang, Binghua; Cao, Wenjun; Sun, Xinghuai

doi:10.1111/aos.13789

Cited by 29 publications

(32 citation statements)

References 53 publications

(55 reference statements)

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“…Moreover, Chang et al [9] performed a small case-control study and found that the concentration of malondialdehyde (MDA) in PACG patients was significantly higher than that of the control subjects. Furthermore, our previous study also reported that the serum level of uric acid, a major antioxidant molecule, was significantly lower in PACG [11] and POAG [12] subjects than that in the control subjects. These results may suggest that evaluating oxidative stress may help in understanding the course of PACG, and oxidative stress damage might be a relevant target for both glaucoma prevention and therapy.…”

Section: Introductionmentioning

confidence: 77%

Relationship between Oxidative Stress Biomarkers and Visual Field Progression in Patients with Primary Angle Closure Glaucoma

Shao

et al. 2020

Oxidative Medicine and Cellular Longevity

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Purpose. To investigate the serum changes of oxidative stress markers and the relationship between these factors and visual field (VF) progression in patients with primary angle closure glaucoma (PACG). Methods. A case-control and a prospective cohort study. A total of 94 patients with PACG and 89 normal controls were enrolled. Furthermore, 94 PACG subjects were followed up for at least two years (once every six months). All participants were evaluated for serum levels of superoxide dismutase (SOD), total antioxidant status (TAS), hydrogen peroxide (H2O2), malondialdehyde (MDA), glutathione peroxidase, glutathione reductase, and detailed eye and systematic examination. Binary logistic regression analysis and Cox regression analysis were performed. Results. The serum levels of SOD and TAS in the PACG group were significantly lower than those in the control group (p<0.001). Meanwhile, PACG subjects had significantly higher levels of MDA and H2O2 than the normal control subjects (p<0.001). Serum levels of TAS (OR=0.773, 95%CI=0.349−0.714, p<0.001), SOD (OR=0.975, 95%CI=0.955−0.995, p<0.001), MDA (OR=1.155, 95%CI=1.080−1.235, p<0.001), and H2O2 (OR=1.216, 95%CI=1.142−1.295, p<0.001) were independent risk/protective factors for PACG. TAS levels (HR=0.041, 95%CI=0.008–0.218, p<0.001), SOD levels (HR=0.983, 95%CI=0.971–0.994, p=0.003), and MDA levels (HR=1.010, 95%CI=1.001–1.018, p=0.015) at baseline were associated with visual field progression. Kaplan–Meier curves reveal that patients with TAS<0.95/SOD<143/MDA>12 had a significantly higher percentage of PACG progression (p<0.05). Conclusions. Decreased levels of TAS and SOD as well as increased levels of MDA at baseline were associated with VF progression in patients with PACG. These findings suggest that oxidative stress was involved in the onset and development of PACG.

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Section: Introductionmentioning

confidence: 77%

Relationship between Oxidative Stress Biomarkers and Visual Field Progression in Patients with Primary Angle Closure Glaucoma

Shao

et al. 2020

Oxidative Medicine and Cellular Longevity

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“…During the baseline visit and final follow-up, the subjects underwent a complete ophthalmologic and medical examination [25, 26, 30]. This began with a standardized ophthalmologic examination performed by a glaucoma specialist.…”

Section: Methodsmentioning

confidence: 99%

“…For biochemical measurements, 4 ml of blood was obtained via standard venipuncture at the antecubital fossae (i.e., anterior elbow veins) on the morning after the subjects had fasted for 8 h and had refrained specifically from purine-rich foods (e.g., offal, seafood, and beans) for 2 days. The methods used to calculate UA levels have previously been described in detail [25, 26]. These studies also reported that UA level reference ranges vary in males (0.2023–0.4165 mmol/l) and females (0.1428–0.3392 mmol/l).…”

Section: Methodsmentioning

confidence: 99%

“…Meanwhile, studies have reported that UA is one of the most important antioxidants in human biological fluids mitigating oxidative damage [8]. For example, a previous study reported significantly lower serum UA levels in patients with PACG [25] and primary open-angle glaucoma [26]. Additionally, these low levels were negatively associated with disease severity.…”

Section: Introductionmentioning

confidence: 99%

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Association between Pretreatment Serum Uric Acid Levels and Progression of Newly Diagnosed Primary Angle-Closure Glaucoma: A Prospective Cohort Study

Shao

Cao

et al. 2019

Oxidative Medicine and Cellular Longevity

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Purpose. Increased evidence reveals that uric acid (UA) may have an important neuroprotective effect through its antioxidant properties. The aim of the present study was to investigate the relationship between pretreatment serum UA levels and the progression of newly diagnosed primary angle-closure glaucoma (PACG). Methods. This prospective observational cohort study included 64 patients with newly diagnosed PACG who were followed up for a mean period of 12.77 months (range: 3–28 months). All subjects underwent a complete ophthalmological examination during the baseline and final follow-up visits, together with the acquisition of blood samples for UA measurements. During the follow-up period, the progression of PACG was defined as a clinical diagnosis of medically uncontrolled intraocular pressure and a loss of visual field with a mean deviation of >1 dB/year. Univariable and multivariable Cox regression models were used to investigate the association between baseline serum UA levels and the progression of PACG. The cumulative probability of progression of glaucoma was analyzed using the Kaplan-Meier method. Results. During follow-up, 32 subjects were defined as progressive PACG, among whom baseline UA values were significantly higher in nonprogressing subjects than in progressing subjects (0.314±0.069 mmol/l versus [vs.] 0.258±0.069 mmol/l, respectively; P=0.002). Similar results were also observed in male and female subgroups (P<0.05). In a multivariable model, a decreased baseline serum UA level was associated with an increased risk for progressing PACG: both in male (hazard ratio [HR] 6.088 [95% confidence interval (CI) 1.163–31.8638]; P=0.032) and female subjects (HR 3.565 [95% CI 1.131–11.236]; P=0.030). Subjects with high UA levels demonstrated higher cumulative probabilities of nonprogressing PACG than those with low UA levels (male [16.67% vs. 80.00%; P=0.0084] and female [29.41% vs. 68.00%; P=0.0182]). Conclusion. An association between high baseline serum UA levels and a decreased risk for progressing PACG was found. This primary finding suggests that high serum UA levels may have a protective role against PACG and could slow disease progression.

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“…The following covariates obtained from the claims data were considered as confounders and were adjusted for in the analysis: age, sex, use of other prescribed medications [antidiabetic drugs, antihypertensives, antidepressants, benzodiazepines, anticoagulants, antiplatelet drugs, aspirin, antigout drugs, and non-statins (including fibrates, ezetimibe, and nicotinic acid)], and diagnosis of certain diseases (diabetes mellitus, hypertension, myocardial infarction, chronic heart failure, cerebrovascular disease, renal disorders, liver disorders, pulmonary disease, and cancer). The covariates benzodiazepines, antigout drugs, renal disorders, and liver disorders were included because previous studies have reported that benzodiazepines are associated with acute angle-closure glaucoma [22], serum uric acid levels are associated with primary open-angle glaucoma [23], and nonalcoholic fatty liver disease [24] and hemodialysis [25] are associated with elevated intraocular pressure. The Charlson comorbidity index [26] for prediction of mortality was also calculated using ICD-10 code and included as a covariate.…”

Section: Exposures Outcomes and Covariatesmentioning

confidence: 99%

Comparison between high and low potency statins in the incidence of open-angle glaucoma: A retrospective cohort study in Japanese working-age population

et al. 2020

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Some findings on the association between glaucoma and statins in the Asian population have been reported. We conducted a retrospective cohort study using health insurance claims data maintained by the JMDC Inc., which comprises data on about three million individuals representing 2.4% of the Japanese population. The association between the potency of statins and open-angle glaucoma in Japanese working-age population was examined using a commercially available health insurance claims and enrollment database. We identified 117,036 patients with a prescription of statins between January 1, 2005 and March 31, 2014; 59,535 patients were selected as new statin users. Of these, 49,671 (83%) patients without glaucoma who were prescribed statins for the first time were part of the primary analysis. New users of statin were defined as those with a prescription of statin at the beginning of the study, but without a prescription six months earlier. The cohort comprised 29,435 (59%) and 20,236 (41%) patients with a prescription of high-potency statin (atorvastatin and rosuvastatin) and low-potency statin (pravastatin, fluvastatin, pitavastatin, and simvastatin), respectively. Using Cox proportional hazards regression analysis, hazard ratios (HRs) were estimated for glaucoma adjusted for baseline characteristics. Although some baseline characteristics were not similar between the high-potency and low-potency statin groups, the standardized difference for all covariates was less than 0.1. No associations were found between high-potency statin use and glaucoma (adjusted HR = 1.08; 95% confidence interval, 0.93-1.24) in the primary analyses, using the risk for glaucoma in the low-potency statin group as reference. The risk of glaucoma with individual statin use was not significantly different from that with pravastatin. No significant association was found between high-potency statins and the increased risk of glaucoma in Japanese working-age population. Further studies are needed to examine the association between statins and glaucoma in the elderly population.

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Association of serum uric acid levels with primary open‐angle glaucoma: a 5‐year case–control study

Abstract: Primary open-angle glaucoma patients have lower UA levels; however, a negative association between UA levels and disease severity was evident in male patients.

Cited by 29 publications

References 53 publications

Relationship between Oxidative Stress Biomarkers and Visual Field Progression in Patients with Primary Angle Closure Glaucoma

Relationship between Oxidative Stress Biomarkers and Visual Field Progression in Patients with Primary Angle Closure Glaucoma

Association between Pretreatment Serum Uric Acid Levels and Progression of Newly Diagnosed Primary Angle-Closure Glaucoma: A Prospective Cohort Study

Comparison between high and low potency statins in the incidence of open-angle glaucoma: A retrospective cohort study in Japanese working-age population

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