Serum Calcium Level as a Useful Surrogate for Risk of Elevated Intraocular Pressure

Abstract

Background: Uncontrolled intraocular pressure (IOP) plays a principal role in the deterioration of glaucoma, and the intraocular pressure is also accepted as the most important modifiable factor. Calcium ion has been found to play a vital role in regulating the resistance of the trabecular meshwork in humans. However, the relationship between serum total calcium and IOP has not been well-established. Methods: We investigated the association between serum total calcium and the IOP in a large population (14,037 eligible participants, consisting of 7712 men and 6325 women, were included) at the Tri-Service General Hospital from 2010 to 2016. Several models of covariate adjustments associated with IOP were designed. Univariate and multivariate regression analysis was performed for gender differences in the association between the serum total calcium level and IOP. Results: There was a significant relationship between serum total calcium levels and IOP in women and men with a β coefficient of 0.050 (95% confidence interval (CI), 0.030–0.069) and 0.025 (95%CI, 0.007–0.043). Notably, participants in the highest tertiles of serum total calcium levels had significantly higher IOP, in both the male and female participants. Conclusions: Our study shows that IOP is significantly associated with serum total calcium levels in a large Asian population. This study supports the notion that serum total calcium may play an important role in groups at high risk for elevated IOP.

The Association Between Age and Systemic Variables and the Longitudinal Trend of Intraocular Pressure in a Large-Scale Health Examination Cohort

“…The mechanism has been discussed with an association with cardiometabolic conditions, including hypertension, diabetes, postprandial glucose, coronary atherosclerosis, and obesity. 71 In contrast, current results have suggested that calcium induces the longitudinal decrease of IOP, even independent from such conditions. Notably, calcium would be deemed to be most clinically relevant by comparing the coefficients and the P values of the significant blood parameters (see Table 2 ).…”

“… 70 These mechanisms had been believed to be applied to calcium in the aqueous humor in eyes with glaucoma; however, a more recent study has revealed a clear association between serum calcium and IOP even in healthy subjects. 71 This was a result of a sufficiently large healthy population (14,037 subjects); however, the investigation was performed merely in the cross-sectional manner. The mechanism has been discussed with an association with cardiometabolic conditions, including hypertension, diabetes, postprandial glucose, coronary atherosclerosis, and obesity.…”

It Is All about Pressure

“…The study showed significant and important serum and AH levels of GDF15 in patients with POAG when compared to controls. The paper entitled "Serum Calcium Level as a Useful Surrogate for Risk of Elevated Intraocular Pressure" [20] also looked at possible factors associated with glaucoma, and found that high serum total calcium levels were significantly associated with elevated IOP in a large cohort of Asians. Studies like the ones reported here can help find potential biomarkers for the diagnosis, management and prognosis of glaucoma, in addition to providing better understanding of the physiological pathway mechanisms involved in the disease process and in identifying future specific targets in the development of new treatments for glaucoma.…”