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ARVO 2023: Risk factors for glaucoma associated with BMI, waist circumference, and metabolic syndrome


Body mass index (BMI), central obesity, and the metabolic syndrome may be deciding risk factors in glaucoma.

an image of a woman standing on a scale with a measuring tape in front of her. (Image Credit: AdobeStock/NewAfrica)

The likelihood of development of glaucoma was less in patients who were overweight, obese, or had central obesity. (Image Credit: AdobeStock/NewAfrica)

Jennifer E. Lee, MD, from the University of California Los Angeles David Geffen School of Medicine, Los Angeles, and colleagues found that the likelihood of development of glaucoma was less in patients who were overweight, obese, or had central obesity. However, those with metabolic syndrome or a high metabolic syndrome severity score were more likely to develop glaucoma, findings that suggested that obesity alone is not enough to increase their glaucoma risk.

The investigators reported these findings at the Association for Research in Vision and Ophthalmology annual meeting.

The goal of this study was to improve the outcomes of patients with glaucoma, considering the worldwide impact that the disease has on vision. Obesity has been considered as a potential risk factor for the disease, but the results of various studies to now have not been definitive in that regard.

The investigators used the National Institute of Health’s “All of Us” (AoU) database to evaluate the association between glaucoma and various parameters, ie, body mass index (BMI), central obesity, and the metabolic syndrome.

The researchers searched the AoU database for patients 40 years and older who had electronic health record and BMI data available. They explained that the primary exposures were the BMI, central obesity, metabolic syndrome and the metabolic syndrome severity score, the last of whichis based on confirmatory factor analysis of components of the metabolic syndrome, ie, blood pressure, triglycerides, high density lipoprotein, central obesity, and blood glucose. The electronic health records were used to identify the diagnosis of glaucoma.

Of the 156,476 patients included in the analysis, 5.52% had glaucoma.

Based on multivariate logistic regression analyses that adjusted for age, sex, race, education, and income in all analyses and for arterial pressure, hyperlipidemia, and diabetes in the analyses of BMI and central obesity, the patients who were overweight, obese, or had central obesity had a lower risk of developing glaucoma.

In contrast, the patients with the metabolic syndrome and a high metabolic syndrome severity score had higher odds of having glaucoma compared to those without.

The authors concluded that their results suggested that the metabolic syndrome, rather than obesity alone, may be a risk factor for glaucoma and they called for future research to examine the role of the metabolic syndrome in the pathogenesis of glaucoma. Such research would be beneficial to identify potential strategies for improved disease management, they emphasized.

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