Di Rosa Isabel, Halimitabrizi Mina, Salowe Rebecca, Augello Patrick, Zhu Di, Chen Yineng, Sankar Prithvi, Addis Victoria, Ying Gui-Shuang, O'Brien Joan
From the Center for Genetics of Complex Disease, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Am J Ophthalmol. 2025 Mar;271:119-126. doi: 10.1016/j.ajo.2024.10.023. Epub 2024 Oct 28.
Investigate the relationship between body mass index (BMI) and primary open-angle glaucoma (POAG) in an African ancestry cohort from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study.
Retrospective, cross-sectional "case-control" comparison study.
A total of 6,634 POAAGG study subjects were eligible: 2,977 cases and 3,657 controls. Ocular and demographic data were collected from on-site exams, standardized interviews, and electronic medical records. BMI was calculated: weight(kg)/height(m), and categorized as low (<18.5), moderate (18.5-24.9), high (25.0-29.9), or very high (≥30). Structural and functional POAG progression were assessed by annual rate of change in retinal nerve fiber layer thickness and visual field mean deviation, respectively, using a linear mixed-effects model. Regression analyses evaluated associations of BMI with POAG status, phenotype, and progression.
Lower BMI was associated with increased POAG risk (aOR[95% confidence interval], 1.02 [1.007,1.023] per kg/m decrease in BMI, p = .0003). In cases, low BMI was associated with larger cup-to-disc ratio (p = .007) and worse visual acuity (p = .04). Fast functional POAG progressors had a significantly lower mean BMI than slow progressors (25.7 vs. 30.0 kg/m, p = .04).
In this African ancestry cohort, low BMI was associated with increased POAG risk. POAG cases with low BMI were more likely to have larger cup-to-disc ratios, worse visual acuity, and faster functional progression, indicating more severe glaucoma.
在原发性开角型非裔美国人青光眼遗传学（POAAGG）研究中的非洲裔队列中，调查体重指数（BMI）与原发性开角型青光眼（POAG）之间的关系。
回顾性横断面“病例对照”比较研究。
共有6634名POAAGG研究对象符合条件：2977例病例和3657名对照。通过现场检查、标准化访谈和电子病历收集眼部和人口统计学数据。计算BMI：体重（千克）/身高（米），并分类为低（<18.5）、中（18.5 - 24.9）、高（25.0 - 29.9）或非常高（≥30）。分别使用线性混合效应模型，通过视网膜神经纤维层厚度和视野平均偏差的年变化率评估POAG的结构和功能进展。回归分析评估BMI与POAG状态、表型和进展的关联。
较低的BMI与POAG风险增加相关（调整后的比值比[95%置信区间]，BMI每降低1千克/米为1.02[1.007,1.023]，p = 0.0003）。在病例中，低BMI与较大的杯盘比相关（p = 0.007）和较差的视力相关（p = 0.04）。功能进展快的POAG患者的平均BMI显著低于进展慢的患者（25.7对30.0千克/米，p = 0.04）。
在这个非洲裔队列中，低BMI与POAG风险增加相关。低BMI的POAG病例更有可能有较大的杯盘比、较差的视力和更快的功能进展，表明青光眼更严重。
