Macri Carmelo Z, Wong Christopher X, Tu Samuel J, Sun David F, Casson Robert, Singh Kuldev, Wang Sophia, Sun Michelle T
Discipline of Ophthalmology & Visual Sciences, The University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Department of Cardiology, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Clin Exp Ophthalmol. 2025 Mar;53(2):133-139. doi: 10.1111/ceo.14467. Epub 2024 Nov 18.
We sought to investigate the association between obesity, metabolic syndrome, and metabolic health with incident primary open-angle glaucoma (POAG).
We included 103 249 UK Biobank participants without previously diagnosed glaucoma or glaucoma-related procedures at enrolment. The primary outcome was POAG identified from diagnostic coding via linked hospital inpatient and primary care data. We used multivariable Cox regression to evaluate the association of body mass index (BMI), and the interaction with metabolic syndrome (MetS) and a novel definition of metabolic health status with incident POAG. BMI was modelled as a time-varying coefficient. Multivariable analysis was adjusted for age, sex, ethnicity, intraocular pressure, spherical equivalent, polygenic risk score and stratified by the presence of primary care data.
There were 471 events of incident POAG over 464 117 580 person-years and a mean follow-up of 12.6 years [Correction added on 18 December 2024, after first online publication: in the "Results" section of the Abstract, the events of incident POAG have been corrected from 647 to 471]. At baseline (time = 0), each one unit increase in BMI was associated with a 9% lower hazard of incident glaucoma (HR 0.91, CI 0.86-0.97, p = 0.0066). Further, compared to a normal BMI range of 18.5-24 kg/m, a BMI ≥30 kg/m was associated with a 65% relative hazard reduction (HR 0.35, CI 0.16-0.80, p = 0.012). There was no significant interaction between BMI and metabolic syndrome or metabolic health (all p > 0.05).
The effect of BMI on the risk of incident POAG varied with time. Higher BMI was associated with a decreased risk of incident POAG in this large prospective cohort. There was no significant association with systemic metabolic health.
我们旨在研究肥胖、代谢综合征和代谢健康与原发性开角型青光眼（POAG）发病之间的关联。
我们纳入了103249名英国生物银行参与者，这些参与者在入组时未被诊断患有青光眼或接受过与青光眼相关的手术。主要结局是通过关联医院住院患者和初级保健数据的诊断编码确定的POAG。我们使用多变量Cox回归来评估体重指数（BMI）、与代谢综合征（MetS）的相互作用以及代谢健康状况的新定义与POAG发病之间的关联。BMI被建模为一个随时间变化的系数。多变量分析对年龄、性别、种族、眼压、等效球镜、多基因风险评分进行了调整，并按初级保健数据的存在情况进行分层。
在464117580人年的时间里，有471例原发性开角型青光眼发病事件，平均随访12.6年[2024年12月18日首次在线发表后添加的更正：在摘要的“结果”部分，原发性开角型青光眼发病事件已从647例更正为471例]。在基线时（时间=0），BMI每增加一个单位，青光眼发病风险降低9%（风险比0.91，置信区间0.86-0.97，p=0.0066）。此外，与正常BMI范围18.5-24kg/m²相比，BMI≥30kg/m²与相对风险降低65%相关（风险比0.35，置信区间0.16-0.80，p=0.012）。BMI与代谢综合征或代谢健康之间没有显著的相互作用（所有p>0.05）。
BMI对原发性开角型青光眼发病风险的影响随时间而变化。在这个大型前瞻性队列中，较高的BMI与原发性开角型青光眼发病风险降低相关。与全身代谢健康没有显著关联。
