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Relationship Between BMI and IOP in Men and Women

Relationship Between Body Mass Index and Intraocular Pressure in Men and Women

A Population-Based Study

Eytan Cohen, MD; Michal Kramer, MD; Tzippy Shochat, MSc; Elad Goldberg, MD; Moshe Garty, MD; Ilan Krause, MD

| Disclosures

J Glaucoma. 2016;25(5):e509-e513. 

 

Abstract and Introduction

Abstract

Purpose: To assess the possibility of a relationship between body mass index (BMI) and intraocular pressure (IOP) in both men and women.

Materials and Methods: A retrospective cross-sectional analysis of a database from a screening center in Israel which assessed 18,575 subjects, within an age range 20 to 80 years.

Results: The mean (±SD) age of the study sample was 46 (±10) years, 68% were men. A positive linear correlation was found between BMI and IOP for both men and women (r=0.166, P<0.0001 in men and r=0.202, P<0.0001 in women). Mean (95% confidence interval) IOP in subjects with BMI<25 kg/m2 was 12.8 mm Hg (range, 12.7 to 12.9 mm Hg) and increased significantly to 13.4 (range, 13.3 to 13.5 mm Hg); 13.9 mm Hg (range, 13.8 to14.0 mm Hg), and 14.3 mm Hg (range, 14.1 to 14.5 mm Hg) for BMI subcategories 25 to 29.9, 30 to 35, and >35 kg/m2, respectively (P<0.0001). These differences remained significant after multivariate adjustment for age, hypertension, and diabetes mellitus (P<0.0001). Similar multivariate adjustments showed that the coefficient factors for BMI (95% confidence interval) affecting IOP were 0.087 (range, 0.076 to 0.098) P<0.0001 and 0.070 (range, 0.058 to 0.082) P<0.0001 for men and women respectively, indicating that in men and women, the changes in IOP associated with a 10 kg/m2 increase in BMI were 0.9 and 0.7 mm Hg, respectively. Subjects with abnormal BMI compared with subjects with normal BMI had increased odds ratio of having IOP≥18 mm Hg after adjusting for confounding factors (P<0.001).

Conclusions: This study shows that obesity is an independent risk factor for increasing IOP in both men and women. We consider this finding particularly pertinent in the context of the current obesity epidemic.

Introduction

After cataracts, glaucoma is the second leading cause of blindness worldwide.[1] It is the main reason for blindness among African Americans.[2,3]

The major risk factors for developing open-angle glaucoma include age, black race, family history, and elevated intraocular pressure (IOP).[4,5] Other risk factors include hypertension,[6] diabetes mellitus,[7] and hypothyroidism.[8] A large body of literature has described the association between elevated IOP and both the development and progression of open-angle glaucoma.[9–11] Treatment of glaucoma, however, still focuses on lowering IOP.

Overweight and obesity have become global epidemics[12] and a question has arisen concerning a possible relationship between obesity and IOP. Indeed, several studies have assessed the possible relationship between body mass index (BMI) and IOP. Most studies have shown a positive relationship between BMI and IOP,[13–21] whereas in 2 studies, carried out in a small cohort of children and adults, no such relationship could be found.[22,23] Studies have been carried out in a subgroup population from the far East;[13–16,21] with children[17,22] and elderly subjects.[18] Only 3 studies have been carried out in western populations,[18–20] all of which included a relatively small number of subjects and did not isolate the effect of BMI from common comorbidities such as hypertension and diabetes mellitus.

The aim of the current study was to assess a possible relationship between BMI and IOP in both men and women in a large cohort from Israel.

 
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Table 1.  Baseline Characteristics of the Study Population (18,575 Subjects)
  Men [N=12,709 (68%)] Women [N=5866 (32%)] P
Age [mean (SD)] (y) 45.9 (10.1) 46.1 (10.3) 0.180
IOP [mean (SD)] (mm Hg) 13.4 (2.5) 13.0 (2.2) <0.001
BMI [mean (SD)] (kg/m2) 27.2 (4.0) 25.5 (4.9) <0.001
Hypertension (%) 12.3 5.8 <0.001
Diabetes mellitus (%) 4.1 2.7 <0.001
Smoker (%) 16.5 17.1 0.283
Alcohol consumption (%) 18.7 11.0 <0.001
eGFR (CKD-EPI) [mean (SD)] (mL/min/1.73m2) 97.3 (14.0) 101.4 (14.1) <0.001
HDL cholesterol [mean (SD)] (mg/dL) 47.1 (10.1) 59.8 (13.5) <0.001
LDL cholesterol [mean (SD)] (mg/dL) 120.6 (30.8) 116.5 (31.2) <0.001
Triglycerides [mean (SD)] (mg/dL) 137.1 (90.8) 106.4 (61) <0.001
TSH [mean (SD)] (mIU/L) 1.87 (1.82) 2.08 (3.1) <0.001

BMI indicates body mass index; CKD-EPI, chronic kidney disease epidemiology collaboration; eGFR, estimated glomerular filtration rate; HDL, high-density lipoprotein; IOP, intraocular pressure; LDL, low-density lipoprotein; TSH, thyroid stimulating hormone.

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Table 2.  Multivariable Adjustment for Confounding Factors Associated With Intraocular Pressure in Men and Women
Variable Men Women
Coefficient 95% Confidence Interval P Coefficient 95% Confidence Interval P
BMI 0.087 0.076–0.098 <0.0001 0.070 0.058–0.082 <0.0001
Age 0.025 0.020–0.029 <0.0001 0.025 0.020–0.031 <0.0001
Hypertension (y/n) 0.200 0.057–0.342 <0.0001 0.355 0.106–0.605 0.005
Diabetes mellitus (y/n) 0.250 0.029–0.470 <0.0001 0.434 0.086–0.781 0.015

BMI indicates body mass index.

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Table 3.  Odds Ratio (95% Confidence Intervals) of Having IOPZ18mm Hg Comparing Each Abnormal BMI Category to the Reference Normal BMI
  Men Women
Model 1 Model 2 Model 3 Model 1 Model 2 Model 3
BMI (kg/m2)            
   <25 1 1 1 1 1 1
   25–29 1.52 (1.25–1.85)* 1.40 (1.15–1.71)* 1.38 (1.14–1.68)* 1.77 (1.24–2.53)* 1.40 (0.96–2.20)** 1.37 (0.95–1.99)***
   30–35 2.19 (1.74–2.75)* 1.94 (1.54–2.45)* 1.86 (1.48–2.35)* 3.57 (2.40–5.29)* 2.64 (1.76–3.40)* 2.47 (1.63–3.73)*
   >35 3.38 (2.50–4.59)* 3.10 (2.28–4.21)* 2.86 (2.09–3.91)* 4.00 (2.42–6.60)* 3.06 (1.84–5.10)* 2.73 (1.62–4.60)*

Model 1=unadjusted; Model 2=adjustment for age; Model 3=adjustment for age, hypertension, and diabetes mellitus.
*P<0.001.
**P=0.07.
***P=0.09.
BMI indicates body mass index.

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References

  1. Kingman S. Glaucoma is second leading cause of blindness globally. Bull World Health Organ. 2004;82:887–888.

  2. Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121:2081–2090.

  3. Sommer A, Tielsch JM, Katz J, et al. Racial differences in the cause-specific prevalence of blindness in east Baltimore. N Engl J Med. 1991;325:1412–1417.

  4. Kwon YH, Fingert JH, Kuehn MH, et al. Primary open-angle glaucoma. N Engl J Med. 2009;360:1113–1124.

  5. Czudowska MA, Ramdas WD, Wolfs RC, et al. Incidence of glaucomatous visual field loss: a ten-year follow-up from the Rotterdam Study. Ophthalmology. 2010;117:1705–1712.

  6. Zhao D, Cho J, Kim MH, et al. The association of blood pressure and primary open-angle glaucoma: a meta-analysis. Am J Ophthalmol. 2014;158:615–627.

  7. Zhao D, Cho J, Kim MH, et al. Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis. Ophthalmology. 2015;122:72–78.

  8. Girkin CA, McGwin G Jr, McNeal SF, et al. Hypothyroidism and the development of open-angle glaucoma in a male population. Ophthalmology. 2004;111:1649–1652.

  9. Ekstrom C. Risk factors for incident open-angle glaucoma: a population-based 20-year follow-up study. Acta Ophthalmol. 2012;90:316–321.

  10. Nemesure B, Honkanen R, Hennis A, et al. Incident openangle glaucoma and intraocular pressure. Ophthalmology. 2007;114:1810–1815.

  11. Martinez-Bello C, Chauhan BC, Nicolela MT, et al. Intraocular pressure and progression of glaucomatous visual field loss. Am J Ophthalmol. 2000;129:302–308.

  12. James PT, Leach R, Kalamara E, et al. The worldwide obesity epidemic. Obes Res. 2001;9(suppl 4):228S–233S.

  13. Mori K, Ando F, Nomura H, et al. Relationship between intraocular pressure and obesity in Japan. Int J Epidemiol. 2000;29:661–666.

  14. Yoshida M, Ishikawa M, Karita K, et al. Association of blood pressure and body mass index with intraocular pressure in middle-aged and older Japanese residents: a cross-sectional and longitudinal study. Acta Med Okayama. 2014;68:27–34.

  15. Wang YX, Xu L, Zhang XH, et al. Five-year change in intraocular pressure associated with changes in arterial blood pressure and body mass index. The Beijing eye study. PLoS One. 2013;8:e77180.

  16. Jang HD, Kim DH, Han K, et al. Relationship between intraocular pressure and parameters of obesity in Korean adults: The 2008–2010 Korea National Health and Nutrition Examination Survey. Curr Eye Res. 2015;40:1008–1017.

  17. Akinci A, Cetinkaya E, Aycan Z, et al. Relationship between intraocular pressure and obesity in children. J Glaucoma. 2007;16:627–630.

  18. Bulpitt CJ, Hodes C, Everitt MG. Intraocular pressure and systemic blood pressure in the elderly. Br J Ophthalmol. 1975;59:717–720.

  19. Klein BE, Klein R, Linton KL. Intraocular pressure in an American community. The Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1992;33:2224–2228.

  20. Geloneck MM, Crowell EL, Wilson EB, et al. Correlation between intraocular pressure and body mass index in the seated and supine positions. J Glaucoma. 2015;24:130–134.

  21. Kim MJ, Park KH, Kim CY, et al. The distribution of intraocular pressure and associated systemic factors in a Korean population: the Korea National Health and Nutrition Examination Survey. Acta Ophthalmol. 2014;92:e507–e513.

  22. Albuquerque LL, Gaete MI, Figueiroa JN, et al. The correlation between body mass index and intraocular pressure in children. Arq Bras Oftalmol. 2013;76:10–12.

  23. Karadag R, Arslanyilmaz Z, Aydin B, et al. Effects of body mass index on intraocular pressure and ocular pulse amplitude. Int J Ophthalmol. 2012;5:605–608.

  24. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. The AGIS Investigators. Am J Ophthalmol. 2000;130:429–440.

  25. Wu SY, Leske MC. Associations with intraocular pressure in the Barbados Eye Study. Arch Ophthalmol. 1997;115:1572–1576.

  26. Shiose Y. The aging effect on intraocular pressure in an apparently normal population. Arch Ophthalmol. 1984;102:883–887.

  27. Shiose Y. Intraocular pressure: new perspectives. Surv Ophthalmol. 1990;34:413–435.

  28. Nedungadi TP, Clegg DJ. Sexual dimorphism in body fat distribution and risk for cardiovascular diseases. J Cardiovasc Transl Res. 2009;2:321–327.

  29. Vajaranant TS, Pasquale LR. Estrogen deficiency accelerates aging of the optic nerve. Menopause. 2012;19:942–947.

  30. Cedrone C, Mancino R, Cerulli A, et al. Epidemiology of primary glaucoma: prevalence, incidence, and blinding effects. Prog Brain Res. 2008;173:3–14.

  31. Heijl A, Leske MC, Bengtsson B, et al. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002;120:1268–1279.

  32. Gasser P, Stumpfig D, Schotzau A, et al. Body mass index in glaucoma. J Glaucoma. 1999;8:8–11.

  33. Flammer J, Orgul S. Optic nerve blood-flow abnormalities in glaucoma. Prog Retin Eye Res. 1998;17:267–289.

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Authors and Disclosures

Eytan Cohen, MD*†‡, Michal Kramer, MD‡§, Tzippy Shochat, MSc*, Elad Goldberg, MD*‡, Moshe Garty, MD*‡|| and Ilan Krause, MD*‡

Departments of *Medicine F-Recanati; §Ophthalmology; †Clinical Pharmacology Unit; ||Recanati Center for Preventive Medicine, Rabin Medical Center, Petah Tikva; and ‡Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.

Reprints
Eytan Cohen, MD, Clinical Pharmacology Unit, Rabin Medical Centre (Beilinson Campus), Petah Tikva 49100, Israel (e-mail: dreytancohen@gmail.com).

Disclosure
The authors declare no conflict of interest.

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