Abstract
Based on reports of an association between elevated intraocular pressure (IOP) and metabolic syndrome (MetS), and the major role of insulin resistance (IR) in MetS pathogenesis, a positive association between IOP and IR has been hypothesized. Although Asian populations tend to have lower body mass indices (BMIs) than Western populations, they tend to have a higher risk of developing MetS. This study examined the hypothesis that the association between IOP and IR differs by obesity status in an Asian population, by examining a nationally representative sample of South Korean adults. Data collected from 4,621 South Korean adults regarding demographic, lifestyle, and laboratory parameters by the 2010 Korea National Health and Nutrition Examination Survey were subjected to linear regression analysis to evaluate the relationship between IOP and metabolic profiles. After adjusting for confounding factors, the data were subjected to multiple linear regression analysis to examine the association between IR, as measured by the homeostasis model assessment of insulin resistance (HOMA-IR), and IOP. Obesity was defined as BMI≥27.5 kg/m2, and the subjects were divided into obese vs. non-obese groups for investigation of the association between IR and IOP according to obesity status. IOP was found to correlate with fasting blood sugar, total cholesterol, insulin, and HOMA-IR values in non-obese men; and with BMI, waist circumference, triglycerides, total cholesterol, HOMA-IR, and low-density lipoprotein cholesterol values in non-obese women, whereas no association between IOP and IR was found in obese men or women. IOP was significantly associated with IR in non-obese men and women after adjusting for age, and in non-obese men after adjusting for age, BMI, and lifestyle and demographic factors. These findings indicate that a positive and independent relationship exists between IOP and IR in non-obese individuals only, suggesting that other factors likely contribute to IOP elevation in obese individuals.
Highlights
Intraocular pressure (IOP) is determined by the balance between aqueous humor secretion and outflow, and is closely associated with the development of glaucomatous optic nerve damage [1, 2]
This study examined data collected by the 2010 Korea National Health and Nutrition Examination Survey (KNHANES), a cross-sectional survey conducted by the Korea Center for Disease Control and Prevention and approved by its institutional review board
In non-obese men, IOP was found to correlate with fasting blood sugar (FBS) level (p50.014), total cholesterol (TC) level (p50.004), insulin level (p50.031), and log of HOMA-insulin resistance (IR) value (p50.091)
Summary
Intraocular pressure (IOP) is determined by the balance between aqueous humor secretion and outflow, and is closely associated with the development of glaucomatous optic nerve damage [1, 2] As it can be lowered by medications or surgery, IOP is the only known modifiable risk factor for glaucomatous optic nerve damage [3]. Based on observations that IR plays a major role in the pathogenesis of MetS, a positive association between IOP and IR has been hypothesized In support of this hypothesis, a previous hospitalbased study investigating the link between IOP and IR found a positive association between IR indices and IOP, even after adjusting for other risk factors [9]. This study had several potential limitations, including selection bias due to the relatively small sample and its single-center design
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