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The Association between Adiposity and the Risk of Glaucoma: A Meta-Analysis 时间:2017-06-22 12:27 来源:未知作者:admin 点击: 次 Abstract:Purpose. This meta-analysis was conducted to determine the potential association between adiposity and glaucoma incidence. Materials and Methods. A comprehensive literature search was performed in PubMed and ISI Web of Science. A meta-analysis was conducted using STATA software. Results. Fifteen eligible studies involving 2,445,980 individuals were included to investigate the association between adiposity and glaucoma incidence. The relative risks (RRs) were pooled with 95% confidence intervals (CI) by using a random-effects model. The pooled RR between adiposity and elevated intraocular pressure (IOP) was 1.73 (95% CI, 1.18–2.54), whereas that between adiposity and open-angle glaucoma (OAG) was 0.97 (95% CI, 0.83–1.13). The pooled RR between abdominal adiposity and glaucoma was 1.28 (95% CI, 1.15–1.41), whereas that between general adiposity and glaucoma was 1.09 (95% CI, 0.87–1.37). Results of subgroup analysis by sex indicated the association between adiposity and glaucoma in the female group (RR, 1.31; 95% CI, 1.05–1.64), but not in the male group (RR, 1.11; 95% CI, 0.77–1.60). The pooled RR of cohort studies and cross-sectional studies were 1.00 (95% CI, 0.84–1.20) and 1.22 (95% CI, 0.89–1.66), respectively. Conclusions. Adiposity has a higher risk of elevated IOP, and abdominal adiposity has a positive association with glaucoma, especially in female patients.
1. Introduction
Glaucoma is the first leading cause of irreversible blindness [1]. OAG is the most common type of glaucoma [1]. The main risk factor for OAG is considered to be elevated IOP [2] and other systematic risk factors, including older age, family history of OAG [2], diabetes mellitus [3], alcohol consumption [4], hypertension, and cigarette smoking [5].
Globally, being overweight and adiposity pose a threat to children and adolescents both in developed and developing countries. However, whether anthropometric factors, such as general adiposity or abdominal adiposity, are determinants of OAG or elevated IOP risk is still unclear.
To assess body-weight status, body mass index (BMI) is usually used as an indicator of general adiposity, and waist circumference (WC) or waist-to-hip ratio (WHR) is used for abdominal adiposity [6]. Previous studies [7, 8] have found that a higher BMI is related to glaucoma incidence, while some studies [2, 9] did not report a positive association between BMI and elevated IOP or OAG. Other studies have shown positive trends and significant correlations between higher WC or WHR and elevated IOP [10, 11]. These inconsistent results prompted this meta-analysis to provide a more accurate estimate of the association between adiposity and glaucoma incidence.
2. Materials and Methods
2.1. Search Strategy
This meta-analysis was conducted under the guidance of PRISMA [12]. A systematic search was carried out in PubMed and ISI Web of Science before December 2016, using the following terms: ((metabolic syndrome) OR (overweight) OR (obesity) OR (adiposity) OR (body mass index) OR (BMI) OR (intra-abdominal fat) OR (waist hip ratio) OR (waist circumference) OR (Anthropometric)) AND ((glaucoma) OR (intraocular pressure) OR (ocular hypertension) OR (open-angle glaucoma) OR (normal tension glaucoma) OR (high tension glaucoma)). The search was run according to Medical Subject Headings (MeSH), without restriction to regions, or publication types. The language was restricted to English. Citations for related articles were detected for additional publications. Where several reports related to the same study, only the most recent report was used.