The Relationship Between Components of Metabolic Syndrome and Open-Angle Glaucoma

Abstract

Purpose To determine whether an association exists between various components of metabolic syndrome (diabetes mellitus (DM), systemic arterial hypertension (HTN), hyperlipidemia, and obesity) and open-angle glaucoma (OAG) in a large, diverse group of individuals throughout the United States. Design Longitudinal cohort study. Participants All beneficiaries age ≥40 years continuously enrolled in a managed care network who had ≥1 visit to an eye care provider were identified from 2001–2007. Methods Billing codes were used to identify individuals with OAG and those with components of metabolic syndrome. Cox regression was used to determine the hazard of developing OAG in enrollees with individual components or combinations of components of metabolic syndrome, with adjustment for sociodemographic factors, systemic medical conditions, and other ocular diseases. Main Outcome Measures Hazard of developing OAG. Results Of the 2,182,315 enrollees who met inclusion criteria, 54,558 (2.5%) had OAG. After adjustment for confounding factors, those with DM (hazard ratio (HR)=1.35 [95% confidence interval (CI): 1.21–1.50]) or HTN (HR=1.17 [95% CI: 1.13–1.22]) alone, or in combination, (HR=1.48 [95% CI: 1.39–1.58]) had an increased hazard of developing OAG relative to persons with neither of these conditions. By contrast, persons with hyperlipidemia alone had a 5% decreased hazard of OAG (HR=0.95 [95% CI: 0.91–0.98]). Comorbid hyperlipidemia attenuated the increased hazard between HTN (HR=1.09 [95% CI 1.05–1.12]) or DM (HR=1.13 [95% CI 1.05–1.21]) and OAG. Conclusion Given the increasing prevalence of metabolic disorders in the United States, this study furthers our understanding of risk factors associated with OAG and helps identify persons who may be at risk for this condition.

Translamina Cribrosa Pressure Difference as Potential Element in the Pathogenesis of Glaucomatous Optic Neuropathy

“…52 In contrast, in the study by Pasquale et al, higher body mass index among women was associated with a lower risk of primary open-angle glaucoma with an IOP of 21 mm Hg or less at diagnosis. 53 The findings of other studies support the influence of low CSFP in glaucoma. Patients with slowly growing intracranial tumors close to the inner aperture of the optic nerve canal had an abnormally high prevalence of glaucomatous appearance of the optic nerve head.…”

Trends of barriers to eye care among adults with diagnosed diabetes in Germany, 1997–2012

“…Subjects with diabetes are more likely to develop eye disease, including retinopathy, macular edema, glaucoma, and cataracts [2,3]. Diabetic retinopathy, a consequence of chronic hyperglycemia, leads to substantial morbidity and is a major cause of new cases of legal blindness [3].…”

A Meta-Analysis of Glaucoma Risk in Hyperlipidemic Individuals: A Critical Problem in Design

“…Through a rigorous searching process ( Supplementary Fig. S1), three relevant studies [3][4][5] were included in the final analysis (Supplementary Table S1). Pooled odds ratios demonstrated that hyperlipidemia did not increase the incidence of glaucoma (relative risk, 1.40; 95% confidence interval [CI], 0.73-2.68; Fig.…”