NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada.
NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom.
Ophthalmology. 2023 Oct;130(10):1024-1036. doi: 10.1016/j.ophtha.2023.06.009. Epub 2023 Jun 17.
To examine the association of physical activity (PA) with glaucoma and related traits, to assess whether genetic predisposition to glaucoma modified these associations, and to probe causal relationships using Mendelian randomization (MR).
Cross-sectional observational and gene-environment interaction analyses in the UK Biobank. Two-sample MR experiments using summary statistics from large genetic consortia.
UK Biobank participants with data on self-reported or accelerometer-derived PA and intraocular pressure (IOP; n = 94 206 and n = 27 777, respectively), macular inner retinal OCT measurements (n = 36 274 and n = 9991, respectively), and glaucoma status (n = 86 803 and n = 23 556, respectively).
We evaluated multivariable-adjusted associations of self-reported (International Physical Activity Questionnaire) and accelerometer-derived PA with IOP and macular inner retinal OCT parameters using linear regression and with glaucoma status using logistic regression. For all outcomes, we examined gene-PA interactions using a polygenic risk score (PRS) that combined the effects of 2673 genetic variants associated with glaucoma.
Intraocular pressure, macular retinal nerve fiber layer (mRNFL) thickness, macular ganglion cell-inner plexiform layer (mGCIPL) thickness, and glaucoma status.
In multivariable-adjusted regression models, we found no association of PA level or time spent in PA with glaucoma status. Higher overall levels and greater time spent in higher levels of both self-reported and accelerometer-derived PA were associated positively with thicker mGCIPL (P < 0.001 for trend for each). Compared with the lowest quartile of PA, participants in the highest quartiles of accelerometer-derived moderate- and vigorous-intensity PA showed a thicker mGCIPL by +0.57 μm (P < 0.001) and +0.42 μm (P = 0.005). No association was found with mRNFL thickness. High overall level of self-reported PA was associated with a modestly higher IOP of +0.08 mmHg (P = 0.01), but this was not replicated in the accelerometry data. No associations were modified by a glaucoma PRS, and MR analyses did not support a causal relationship between PA and any glaucoma-related outcome.
Higher overall PA level and greater time spent in moderate and vigorous PA were not associated with glaucoma status but were associated with thicker mGCIPL. Associations with IOP were modest and inconsistent. Despite the well-documented acute reduction in IOP after PA, we found no evidence that high levels of habitual PA are associated with glaucoma status or IOP in the general population.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
研究体力活动（PA）与青光眼和相关特征的关联，评估青光眼遗传易感性是否改变了这些关联，并使用孟德尔随机化（MR）来探究因果关系。
英国生物库中的横断面观察性和基因-环境相互作用分析。使用来自大型遗传联盟的汇总统计数据进行两样本 MR 实验。
分别有自我报告或加速度计衍生的 PA 以及眼内压（IOP；n=94206 和 n=27777）、黄斑内视网膜 OCT 测量（n=36274 和 n=9991）和青光眼状态（n=86803 和 n=23556）数据的英国生物库参与者。
我们使用线性回归评估了自我报告（国际体力活动问卷）和加速度计衍生的 PA 与 IOP 和黄斑内视网膜 OCT 参数的多变量调整关联，并使用逻辑回归评估了与青光眼状态的关联。对于所有结果，我们使用多基因风险评分（PRS）检查了基因-PA 相互作用，该评分结合了 2673 个与青光眼相关的遗传变异的效应。
眼内压、黄斑视网膜神经纤维层（mRNFL）厚度、黄斑神经节细胞-内丛状层（mGCIPL）厚度和青光眼状态。
在多变量调整的回归模型中，我们没有发现 PA 水平或 PA 时间与青光眼状态之间存在关联。较高的总体水平和更多时间进行自我报告和加速度计衍生的 PA 较高水平与较厚的 mGCIPL 呈正相关（每项趋势 P<0.001）。与 PA 最低四分位相比，加速度计衍生的中强度和高强度 PA 最高四分位数的参与者 mGCIPL 分别增厚了+0.57μm（P<0.001）和+0.42μm（P=0.005）。mRNFL 厚度与 PA 无关联。较高的总体 PA 水平与 IOP 适度升高+0.08mmHg（P=0.01）相关，但在加速度计数据中未得到复制。青光眼 PRS 未改变任何关联，MR 分析也不支持 PA 与任何青光眼相关结局之间存在因果关系。
较高的总体 PA 水平和更多时间进行中等强度和高强度 PA 与青光眼状态无关，但与较厚的 mGCIPL 相关。与 IOP 的关联较小且不一致。尽管有明确的 PA 后急性眼压降低的证据，但我们没有发现高水平的习惯性 PA 与普通人群中的青光眼状态或 IOP 相关。
