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Vergroesen JE, Jarrar ZA, Weiss S, Frost F, Ansari AS, Nguyen P, Kraaij R, Medina-Gomez C, Völzke H, Tost F, Amin N, van Duijn CM, Klaver CCW, Jürgens C, Hammond CJ, Ramdas WD. Glaucoma Patients Have a Lower Abundance of Butyrate-Producing Taxa in the Gut. Invest Ophthalmol Vis Sci 2024; 65:7. [PMID: 38315494 PMCID: PMC10851784 DOI: 10.1167/iovs.65.2.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose Glaucoma is an eye disease that is the most common cause of irreversible blindness worldwide. It has been suggested that gut microbiota can produce reactive oxygen species and pro-inflammatory cytokines that may travel from the gastric mucosa to distal sites, for example, the optic nerve head or trabecular meshwork. There is evidence for a gut-eye axis, as microbial dysbiosis has been associated with retinal diseases. We investigated the microbial composition in patients with glaucoma and healthy controls. Moreover, we analyzed the association of the gut microbiome with intraocular pressure (IOP; risk factor of glaucoma) and vertical cup-to-disc ratio (VCDR; quantifying glaucoma severity). Methods The discovery analyses included participants of the Rotterdam Study and the Erasmus Glaucoma Cohort. A total of 225 patients with glaucoma and 1247 age- and sex-matched participants without glaucoma were included in our analyses. Stool samples were used to generate 16S rRNA gene profiles. We assessed associations with 233 genera and species. We used data from the TwinsUK and the Study of Health in Pomerania (SHIP) to replicate our findings. Results Several butyrate-producing taxa (e.g. Butyrivibrio, Caproiciproducens, Clostridium sensu stricto 1, Coprococcus 1, Ruminococcaceae UCG 007, and Shuttleworthia) were less abundant in people with glaucoma compared to healthy controls. The same taxa were also associated with lower IOP and smaller VCDR. The replication analyses confirmed the findings from the discovery analyses. Conclusions Large human studies exploring the link between the gut microbiome and glaucoma are lacking. Our results suggest that microbial dysbiosis plays a role in the pathophysiology of glaucoma.
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Affiliation(s)
- Joëlle E. Vergroesen
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Zakariya A. Jarrar
- Department of Ophthalmology, King's College London, London, United Kingdom
- Department of Twins Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Stefan Weiss
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Fabian Frost
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Abdus S. Ansari
- Department of Ophthalmology, King's College London, London, United Kingdom
- Department of Twins Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Picard Nguyen
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Robert Kraaij
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Frank Tost
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Cornelia M. van Duijn
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Caroline C. W. Klaver
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, University of Basel, Basel, Switzerland
| | - Clemens Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Chris J. Hammond
- Department of Ophthalmology, King's College London, London, United Kingdom
- Department of Twins Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Wishal D. Ramdas
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Hartmann A, Scholz I, Hoffmann EM, Strzalkowska A, Lackner KJ, Münzel T, Wicke FS, Schmidtmann I, Tüscher O, Schattenberg JM, Konstantinides S, Wild PS, Pfeiffer N, Schuster AK. Change of Intraocular Pressure Over 5 Years and its Relationship to Cardiovascular Parameters: Results From the Gutenberg Health Study. Invest Ophthalmol Vis Sci 2024; 65:12. [PMID: 38175640 PMCID: PMC10774695 DOI: 10.1167/iovs.65.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/12/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose To investigate the longitudinal change in intraocular pressure (IOP) over 5 years and its relationship with cardiovascular parameters in a population-based sample in Germany. Methods The Gutenberg Health Study is a prospective, observational, single-center cohort study. The sample was equally stratified for sex, residence, and age decade. IOP was measured with noncontact tonometry at baseline and at 5-year follow-up. Cardiovascular parameters, including body mass index (BMI), systolic blood pressure, and diabetes status, were assessed. Participants without IOP measurement at one time point, who were taking IOP-lowering medications, or who had ophthalmic surgery during the 5-year follow-up interval were excluded, as well as those with glaucoma diagnosis. Univariable and multivariable linear regression analyses were conducted. Results This analysis included 9633 participants (48.9% female). The mean IOP increased from 14.04 ± 2.78 mmHg at baseline to 14.77 ± 2.92 mmHg at 5-year follow-up (P < 0.001). In multivariable linear regression analyses, an increase in BMI was associated with an increase in IOP over time (P < 0.001), whereas a higher baseline BMI was associated with a lower IOP change (P < 0.001). Higher age and male sex were associated with higher IOP change (P < 0.001). A change in systolic blood pressure was associated with IOP change, whereas baseline systolic blood pressure and diabetes status were not associated. Conclusions This population-based study found a relationship between IOP change over 5 years and BMI and systolic blood pressure change, respectively. These findings suggest the importance of monitoring cardiovascular risk factors in IOP management.
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Affiliation(s)
- Alica Hartmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ida Scholz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Esther M. Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alicja Strzalkowska
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Felix S. Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biometry, Epidemiology and Informatics, Mainz, Germany
| | - Oliver Tüscher
- Institute of Molecular Biology, Mainz, Germany
- Clinic for Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Jörn M. Schattenberg
- Metabolic Liver Research Center and Medicine, University Medical Center, Mainz, Germany
| | | | - Philipp S. Wild
- Institute of Molecular Biology, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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3
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Langbøl M, Rovelt J, Saruhanian A, Saruhanian S, Tiedemann D, Baskaran T, Bocca C, Vohra R, Cvenkel B, Lenaers G, Kolko M. Distinct Metabolic Profiles of Ocular Hypertensives in Response to Hypoxia. Int J Mol Sci 2023; 25:195. [PMID: 38203366 PMCID: PMC10779258 DOI: 10.3390/ijms25010195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Glaucoma is a neurodegenerative disease that affects the retinal ganglion cells (RGCs). The main risk factor is elevated intraocular pressure (IOP), but the actual cause of the disease remains unknown. Emerging evidence indicates that metabolic dysfunction plays a central role. The aim of the current study was to determine and compare the effect of universal hypoxia on the metabolomic signature in plasma samples from healthy controls (n = 10), patients with normal-tension glaucoma (NTG, n = 10), and ocular hypertension (OHT, n = 10). By subjecting humans to universal hypoxia, we aim to mimic a state in which the mitochondria in the body are universally stressed. Participants were exposed to normobaric hypoxia for two hours, followed by a 30 min recovery period in normobaric normoxia. Blood samples were collected at baseline, during hypoxia, and in recovery. Plasma samples were analyzed using a non-targeted metabolomics approach based on liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS). Multivariate analyses were conducted using principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA), and univariate analysis using the Wilcoxon signed-rank test and false discovery rate (FDR) correction. Unique metabolites involved in fatty acid biosynthesis and ketone body metabolism were upregulated, while metabolites of the kynurenine pathway were downregulated in OHT patients exposed to universal hypoxia. Differential affection of metabolic pathways may explain why patients with OHT initially do not suffer or are more resilient from optic nerve degeneration. The metabolomes of NTG and OHT patients are regulated differently from control subjects and show dysregulation of metabolites important for energy production. These dysregulated processes may potentially contribute to the elevation of IOP and, ultimately, cell death of the RGCs.
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Affiliation(s)
- Mia Langbøl
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
| | - Jens Rovelt
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Arevak Saruhanian
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
| | - Sarkis Saruhanian
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Veterinary & Animal Sciences, University of Copenhagen, 2000 Frederiksberg, Denmark
| | - Daniel Tiedemann
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Thisayini Baskaran
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
| | - Cinzia Bocca
- Faculté de Santé, Institut MITOVASC, UMR CNRS 6015, INSERM U1083, Université d’Angers, 49933 Angers, France; (C.B.); (G.L.)
- Département de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), 49933 Angers, France
| | - Rupali Vohra
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Barbara Cvenkel
- Department of Ophthalmology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Guy Lenaers
- Faculté de Santé, Institut MITOVASC, UMR CNRS 6015, INSERM U1083, Université d’Angers, 49933 Angers, France; (C.B.); (G.L.)
| | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
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Sharfuddin Ahmed M, Ullah AY, Barman N, Ratan ZA, Mostafa S, Khaleque A, Kabir S, Khan MH, Haque MA. Risk factors associated with elevated intraocular pressure: a population-based study in a rural community of Bangladesh. BMJ Open Ophthalmol 2023; 8:e001386. [PMID: 37844969 PMCID: PMC10582991 DOI: 10.1136/bmjophth-2023-001386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/25/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE High intraocular pressure (IOP) is one of the major modifiable risk factors for glaucoma. The objective was to examine socio-demographic and clinical factors related to IOP. METHODS AND ANALYSIS This study was conducted among 3097 adults residing in a rural area of Bangladesh, with all participants undergoing clinical and ophthalmological evaluations. The measurement of IOP was carried out using of a rebound Tonometer called Icare pro. Multiple logistic regression analysis was employed to identify variables associated to IOP levels of 21 mm Hg or above. Adjusted OR (aOR) and 95% CI were reported. RESULTS This study found that, in total, 9% of the study population had high IOP in one or both eyes. Elevated IOP was significantly associated with respondents who were service holders (aOR 2.52; 95% CI 1.48 to 4.31), had a lower education level (aOR 1.55, 95% CI 1.07 to 2.23), used biomass fuel (aOR 2.00; 95% CI 1.09 to 3.67), belonged to a higher socioeconomic position (aOR 1.55, 95% CI 1.07 to 2.23) and had obesity (aOR 2.00; 95% CI 1.07 to 3.73), hypertension (aOR 1.32; 95% CI 1.01 to 1.73) or history of diabetes (aOR 2.44; 95% CI 1.67 to 3.55), after adjusting for covariates including age, sex, marital status, light source and tobacco consumption, in a multiple regression analysis. CONCLUSION Chronic diseases, such as hypertension and diabetes, obesity and sociodemographic characteristics such as high socioeconomic status and use of biomass fuels, have all been linked to elevated IOP. Patients with chronic diseases should undergo for IOP testing regularly.
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Affiliation(s)
- Md Sharfuddin Ahmed
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Abm Yasin Ullah
- Department of Vitreo-Retina, National Institute of Ophthalmology and Hospital, Dhaka, Bangladesh
| | - Nilima Barman
- Department of Laboratory Medicine, Bangladesh Institute of Research and Rehabilitation of Diabetes Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Zubair Ahmed Ratan
- Department of Biomedical Engineering, Khulna University of Engineering and Technology, Khulna, Bangladesh
| | | | - Abdul Khaleque
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Showkat Kabir
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Maruf Haque Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M Atiqul Haque
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Metabolic Health, Obesity, and Intraocular Pressure. J Clin Med 2023; 12:jcm12052066. [PMID: 36902853 PMCID: PMC10003993 DOI: 10.3390/jcm12052066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 03/08/2023] Open
Abstract
Obesity has been associated with increased intraocular pressure (IOP), but the results are inconsistent. Recently, a subgroup of obese individuals with good metabolic profiles were suggested to have better clinical outcomes than normal-weight individuals with metabolic diseases. The relationships between IOP and different combinations of obesity and metabolic health status have not been investigated. Therefore, we investigated the IOP among groups with different combinations of obesity status and metabolic health status. We examined 20,385 adults aged 19 to 85 years at the Health Promotion Center of Seoul St. Mary's Hospital between May 2015 and April 2016. Individuals were categorized into four groups according to obesity (body mass index (BMI) ≥ 25 kg/m2) and metabolic health status (defined based on prior medical history or abdominal obesity, dyslipidemia, low high-density lipoprotein cholesterol, high blood pressure, or high fasting blood glucose levels upon medical examination). ANOVA and ANCOVA were performed to compare the IOP among the subgroups. The IOP of the metabolically unhealthy obese group (14.38 ± 0.06 mmHg) was the highest, followed by that of the metabolically unhealthy normal-weight group (MUNW, 14.22 ± 0.08 mmHg), then, the metabolically healthy groups (p < 0.001; 13.50 ± 0.05 mmHg and 13.06 ± 0.03 mmHg in the metabolically healthy obese (MHO) and metabolically healthy normal-weight groups, respectively). Subjects who were metabolically unhealthy showed higher IOP compared to their counterparts who were metabolically healthy at all BMI levels, and there was a linear increase in IOP as the number of metabolic disease components increased, but no difference between normal-weight vs. obese individuals. While obesity, metabolic health status, and each component of metabolic disease were associated with higher IOP, those who were MUNW showed higher IOP than those who were MHO, which indicates that metabolic status has a greater impact than obesity on IOP.
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Pezzino S, Sofia M, Greco LP, Litrico G, Filippello G, Sarvà I, La Greca G, Latteri S. Microbiome Dysbiosis: A Pathological Mechanism at the Intersection of Obesity and Glaucoma. Int J Mol Sci 2023; 24:ijms24021166. [PMID: 36674680 PMCID: PMC9862076 DOI: 10.3390/ijms24021166] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The rate at which obesity is becoming an epidemic in many countries is alarming. Obese individuals have a high risk of developing elevated intraocular pressure and glaucoma. Additionally, glaucoma is a disease of epidemic proportions. It is characterized by neurodegeneration and neuroinflammation with optic neuropathy and the death of retinal ganglion cells (RGC). On the other hand, there is growing interest in microbiome dysbiosis, particularly in the gut, which has been widely acknowledged to play a prominent role in the etiology of metabolic illnesses such as obesity. Recently, studies have begun to highlight the fact that microbiome dysbiosis could play a critical role in the onset and progression of several neurodegenerative diseases, as well as in the development and progression of several ocular disorders. In obese individuals, gut microbiome dysbiosis can induce endotoxemia and systemic inflammation by causing intestinal barrier malfunction. As a result, bacteria and their metabolites could be delivered via the bloodstream or mesenteric lymphatic vessels to ocular regions at the level of the retina and optic nerve, causing tissue degeneration and neuroinflammation. Nowadays, there is preliminary evidence for the existence of brain and intraocular microbiomes. The altered microbiome of the gut could perturb the resident brain-ocular microbiome ecosystem which, in turn, could exacerbate the local inflammation. All these processes, finally, could lead to the death of RGC and neurodegeneration. The purpose of this literature review is to explore the recent evidence on the role of gut microbiome dysbiosis and related inflammation as common mechanisms underlying obesity and glaucoma.
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Affiliation(s)
- Salvatore Pezzino
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Maria Sofia
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Luigi Piero Greco
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Giorgia Litrico
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Giulia Filippello
- Complex Operative Unit of Ophtalmology, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Iacopo Sarvà
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Gaetano La Greca
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Saverio Latteri
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
- Correspondence: ; Tel.: +39-0957263584
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Coster D, Rafie A, Savion-Gaiger N, Rachmiel R, Kurtz S, Berliner S, Shapira I, Zeltser D, Rogowski O, Shenhar-Tsarfaty S, Waisbourd M. The effect of body mass index reduction on intraocular pressure in a large prospective cohort of apparently healthy individuals in Israel. PLoS One 2023; 18:e0285759. [PMID: 37196013 DOI: 10.1371/journal.pone.0285759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/01/2023] [Indexed: 05/19/2023] Open
Abstract
PURPOSE To investigate the effect of change in body mass index (BMI) on intraocular pressure (IOP) in a large cohort of apparently healthy volunteers who underwent an annual comprehensive screening examinations. METHODS This study included individuals who were enrolled in the Tel Aviv Medical Center Inflammation Survey (TAMCIS) and had IOP and BMI measurements at their baseline and follow up visits. Relationships between BMI and IOP and the effect of change in BMI on IOP were investigated. RESULTS A total of 7,782 individuals had at least one IOP measurement at their baseline visit, and 2,985 individuals had ≥2 visits recorded. The mean (SD) IOP (right eye) was 14.6 (2.5) mm Hg and mean (SD) BMI was 26.4 (4.1) kg/m2. IOP positively correlated with BMI levels (r = 0.16, p<0.0001). For individuals with morbid obesity (BMI≥35 kg/m2) and ≥2 visits, a change in BMI between the baseline and first follow-up visits correlated positively with a change in the IOP (r = 0.23, p = 0.029). Subgroup analysis of subjects who had a reduction of at least 2 BMI units showed a stronger positive correlation between change in BMI and change in IOP (r = 0.29, p<0.0001). For this subgroup, a reduction of 2.86 kg/m2 of BMI was associated with a reduction of 1 mm Hg in IOP. CONCLUSIONS BMI loss correlated with reduction in IOP, and this correlation was more pronounced among morbidly obese individuals.
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Affiliation(s)
- Dan Coster
- Blavatnik School of Computer Science, Tel-Aviv University, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Ariel Rafie
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Noam Savion-Gaiger
- Division of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Rony Rachmiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Shimon Kurtz
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Shlomo Berliner
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Itzhak Shapira
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - David Zeltser
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ori Rogowski
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shani Shenhar-Tsarfaty
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michael Waisbourd
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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8
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Lee JH, Kwon YJ, Lee HS, Han JH, Joung B, Kim SJ. Fatty Liver Is an Independent Risk Factor for Elevated Intraocular Pressure. Nutrients 2022; 14:nu14214455. [PMID: 36364718 PMCID: PMC9657431 DOI: 10.3390/nu14214455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/14/2022] [Accepted: 10/20/2022] [Indexed: 12/02/2022] Open
Abstract
Elevated intraocular pressure (EIOP) is a major risk factor for glaucoma. Both EIOP and fatty liver share metabolic risk factors, which implies a possible link between EIOP and fatty liver. We aimed to determine the association of fatty liver with EIOP and estimate the effect of fatty liver on EIOP directly and indirectly through insulin resistance. Data from 16,240 adults who underwent health examinations at a single center were analyzed. Multiple logistic regression analyses revealed that fully adjusted odds ratio (OR) and 95% confidence interval (CI) for EIOP in the fatty liver group compared to the non-fatty liver group were 1.36 and 1.08-1.71. Alcoholic liver disease was associated with EIOP in subgroup analysis (OR = 1.80, 95% CI: 1.27-2.56). There was a linear dose-response relationship between EIOP and the severity of fatty liver. Mediation analysis revealed that the total effect of fatty liver on intraocular pressure was 0.90 (0.81-0.99), with a direct effect of 0.81 (0.71-0.90) and an indirect effect of 0.09 (0.06-0.11) through insulin resistance. Fatty liver is independently associated with EIOP. It primarily has a direct effect on intraocular pressure. This suggests that evaluation of EIOP should be considered in patients with fatty liver.
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Affiliation(s)
- Jun-Hyuk Lee
- Nowon Eulji Medical Center, Department of Family Medicine, Eulji University School of Medicine, Seoul 01830, Korea
- Department of Medicine, Graduate School of Hanyang University, Seoul 04763, Korea
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul 16995, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Jee Hye Han
- Nowon Eulji Medical Center, Department of Family Medicine, Eulji University School of Medicine, Seoul 01830, Korea
| | - Boyoung Joung
- Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: (B.J.); (S.J.K.); Tel.: +82-2-2228-8460 (B.J.); +82-2-970-8322 (S.J.K.)
| | - Sung Jin Kim
- Nowon Eulji Medical Center, Department of Ophthalmology, Eulji University School of Medicine, Seoul 01830, Korea
- Correspondence: (B.J.); (S.J.K.); Tel.: +82-2-2228-8460 (B.J.); +82-2-970-8322 (S.J.K.)
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