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The Association Between Body Mass Index and Open-angle Glaucoma in a South Korean Population-based Sample

Lin, Shuai-Chun, MD*,†; Pasquale, Louis, R., MD‡,§; Singh, Kuldev, MD, MPH; Lin, Shan, C., MD*

doi: 10.1097/IJG.0000000000000867
Original Studies

Purpose: The purpose of this article is to investigate the association between body mass index (BMI) and open-angle glaucoma (OAG) in a sample of the South Korean population.

Materials and Methods: The sample consisted of a cross-sectional, population-based sample of 10,978 participants, 40 years of age and older, enrolled in the 2008 to 2011 Korean National Health and Nutrition Examination Survey. All participants had measured intraocular pressure <22 mm Hg and open anterior chamber angles. OAG was defined using disc and visual field criteria established by the International Society for Geographical and Epidemiological Ophthalmology. Multivariable analyses were performed to determine the association between BMI and OAG. These analyses were also performed in a sex-stratified and age-stratified manner.

Results: After adjusting for potential confounding variables, lower BMI (<19 kg/m2) was associated with greater risk of OAG compared with normal BMI (19 to 24.9 kg/m2) [odds ratio (OR), 2.28; 95% confidence interval (CI), 1.22-4.26]. In sex-stratified analyses, low BMI remained adversely related to glaucoma in women (OR, 3.45; 95% CI, 1.42-8.38) but not in men (OR, 1.72; 95% CI, 0.71-4.20). In age-stratified analyses, lower BMI was adversely related to glaucoma among subjects 40- to 49-year old (OR, 5.16; 95% CI, 1.86-14.36) but differences in glaucoma prevalence were not statistically significant between those with low versus normal BMI in other age strata.

Conclusions: Lower BMI was associated with increased odds of OAG in a sample of the South Korean population. Multivariate analysis revealed the association to be statistically significant in women and those in the youngest age stratum.

*Department of Ophthalmology, University of California San Francisco, San Francisco

Department of Ophthalmology, Stanford University, Stanford, CA

Massachusetts Eye and Ear Infirmary, Glaucoma Service

§Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA

Department of Medicine, National Yang-Ming University, Taipei, Taiwan

S.C.L.: full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. K.S., L.R.P., and S.C.L: study concept and design. S.-C.L., S.C.L.: acquisition of data. S.-C.L., L.R.P., K.S., S.C.L.: analysis and interpretation of data. S.-C.L.: drafting of the manuscript. S.C.L., K.S., L.R.P.: critical revision of the manuscript for important intellectual content. S.-C.L.: statistical analysis. S.C.L., L.R.P., K.S.: administrative, technical, and material support. S.C.L: study supervision.

Supported by core grant EY002162 from the National Eye Institute (S.C.L.); by That Man May See Inc. (S.C.L.); by Research to Prevent Blindness (S.C.L.); by the Harvard Glaucoma Center of Excellence and by EY015473 (L.R.P.).

Disclosure: S.L. has served as a paid consultant to Allergan, Eyenovia, IRIDEX, and Aerie Pharmaceuticals. L.R.P. has served as a paid consultant to Eyenovia and to Bausch+Lomb. He has received support to travel to meetings by The Glaucoma Foundations in New York and San Francisco, Glaukos and Aerie Pharmaceuticals. K.S. has served as a paid consultant to Alcon, Allergan, and Novartis. S.-C.L. declares no conflict of interest.

Reprints: Shan C. Lin, MD, 10 Koret Street, Room K301, San Francisco, CA 94143-0730 (e-mail:

Received August 30, 2017

Accepted December 20, 2017

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