Lee Si Hyung, Kim Gyu Ah, Lee Wonseok, Bae Hyoung Won, Seong Gong Je, Kim Chan Yun
Institute of Vision Research, Department of Ophthalmology, Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea.
Department of Ophthalmology, College of Medicine, Bucheon Hospital, Soonchunhyang University, Asan, Korea.
Acta Ophthalmol. 2017 Nov;95(7):e564-e574. doi: 10.1111/aos.13487. Epub 2017 Jul 5.
To assess the associations between vascular and metabolic comorbidities and the prevalence of open-angle glaucoma (OAG) with low-teen and high-teen intraocular pressure (IOP) in Korea.
Cross-sectional data from the Korean National Health and Nutrition Examination Survey from 2008 to 2012 were analysed. Participants diagnosed with OAG with normal IOP were further classified into low-teen IOP (IOP ≤ 15 mmHg) and high-teen IOP (15 mmHg < IOP ≤ 21 mmHg) groups. Using multiple logistic regression analyses, the associations between vascular and metabolic comorbidities and the prevalence of glaucoma were investigated for the low- and high-teen IOP groups.
The prevalences of hypertension, hyperlipidemia, ischaemic heart disease, stroke and metabolic syndrome were significantly higher among subjects with low-teen OAG compared with normal subjects, while only the prevalences of hypertension and stroke were higher among subjects with high-teen OAG compared with normal subjects. In multivariate logistic regression models adjusted for confounding factors, low-teen OAG was significantly associated with hypertension (OR, 1.68; 95% CI, 1.30-2.18), hyperlipidemia (OR, 1.49; 95% CI, 1.07-2.08), ischaemic heart disease (OR, 1.83; 95% CI, 1.07-3.11), stroke (OR, 1.91; 95% CI, 1.12-3.25) and metabolic syndrome (OR, 1.46; 95% CI, 1.12-1.90). High-teen OAG was only associated with stroke (OR, 2.58; 95% CI, 1.20-5.53).
Various vascular and metabolic comorbidities were significantly associated with low-teen OAG, but not with high-teen OAG. These data support the hypothesis that vascular factors play a more significant role in the pathogenesis of OAG with low-teen baseline IOP.
评估韩国血管和代谢合并症与青少年低眼压和高眼压性开角型青光眼（OAG）患病率之间的关联。
分析了2008年至2012年韩国国民健康与营养检查调查的横断面数据。将诊断为眼压正常的OAG参与者进一步分为青少年低眼压组（眼压≤15mmHg）和青少年高眼压组（15mmHg＜眼压≤21mmHg）。使用多元逻辑回归分析，研究青少年低眼压组和高眼压组中血管和代谢合并症与青光眼患病率之间的关联。
青少年低眼压性OAG患者的高血压、高脂血症、缺血性心脏病、中风和代谢综合征患病率显著高于正常受试者，而青少年高眼压性OAG患者中仅高血压和中风患病率高于正常受试者。在调整混杂因素的多变量逻辑回归模型中，青少年低眼压性OAG与高血压（比值比[OR]，1.68；95%置信区间[CI]，1.30 - 2.18）、高脂血症（OR，1.49；95% CI，1.07 - 2.08）、缺血性心脏病（OR，1.83；95% CI，1.07 - 3.11）、中风（OR，1.91；95% CI，1.12 - 3.25）和代谢综合征（OR，1.46；95% CI，1.12 - 1.90）显著相关。青少年高眼压性OAG仅与中风相关（OR，2.58；95% CI，1.20 - 5.53）。
多种血管和代谢合并症与青少年低眼压性OAG显著相关，但与青少年高眼压性OAG无关。这些数据支持血管因素在青少年基线眼压较低的OAG发病机制中起更重要作用的假设。
