Primary Open-Angle African American Glaucoma Genetics (POAAGG) Study: gender and risk of POAG in African Americans.

Naira Khachatryan,Jeffrey D Henderer,Qi Cui,Amanda Lehman,Prithvi S Sankar,Ebenezer Daniel,David W Collins,Victoria Addis,Maxwell Pistilli,Windell Murphy,Joan M O’Brien,Venkata R M Chavali,Eydie G Miller-Ellis,Harini V Gudiseva,Tanisha Moore,Raymond M Fertig,Maureen G Maguire,Rebecca J Salowe

doi:10.1371/journal.pone.0218804

Abstract

The purpose of this study was to investigate the association between gender and primary open-angle glaucoma (POAG) among African Americans and to assess demographic, systemic, and behavioral factors that may contribute to differences between genders. The Primary Open-Angle African American Glaucoma Genetics (POAAGG) study had a case-control design and included African Americans 35 years and older, recruited from the greater Philadelphia, Pennsylvania. Diagnosis of POAG was based on evidence of both glaucomatous optic nerve damage and characteristic visual field loss. Demographic and behavioral information, history of systemic diseases and anthropometric measurements were obtained at study enrollment. Gender differences in risk of POAG were examined using multivariate logistic regression. A total of 2,290 POAG cases and 2,538 controls were included in the study. The percentage of men among cases was higher than among controls (38.6% vs 30.3%, P<0.001). The subjects’ mean age at enrollment was significantly higher for cases compared to controls (70.2±11.3 vs. 61.6±11.8 years, P<0.003). Cases had lower rates of diabetes (40% vs. 46%, P<0.001), higher rates of systemic hypertension (80% vs. 72%, P<0.001), and lower body mass index (BMI) (29.7±6.7 vs. 31.9±7.4, P<0.001) than controls. In the final multivariable model, male gender was significantly associated with POAG risk (OR, 1.64; 95% CI, 1.44–1.87; P<0.001), after adjusting for age, systemic hypertension, diabetes, and BMI. Within the POAAGG study, men were at higher risk of having POAG than women. Pending genetic results from this study will be used to better understand the underlying genetic variations that may account for these differences.

Highlights

Glaucoma is the leading cause of irreversible vision loss worldwide [1]
We examined the unadjusted association between Primary open-angle glaucoma (POAG) and gender, age, diabetes, hypertension, body mass index, and smoking status all other characteristics using logistic regression
Cases had higher rates of systemic hypertension (80% vs. 72%, OR 1.58, 95% CI 1.38–1.81, P

Summary

Introduction

Glaucoma is the leading cause of irreversible vision loss worldwide [1]. Primary open-angle glaucoma (POAG), the most common form of the disease, accounts for the majority (74%) of glaucoma cases [1]. In 2013, more than 44 million individuals were affected by POAG, with this number predicted to increase to between 53 million [2] and 58 million by 2020 [1]. This increased disease burden emphasizes the importance of identifying factors that affect POAG prevalence. Age is a strongly established risk factor for POAG, with prevalence in US adults increasing from 0.6% at ages 40–49 to 8.3% at age 80 or older [3]. Race is a strong risk factor, with African Americans four to five times more likely to have glaucoma than European Americans [4]. There is little agreement on the role of gender in the development and severity of POAG

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