In this study, we evaluated the associations between intraocular pressure (IOP) and systemic and socioeconomic factors.
A population-based cross-sectional study using a nation-wide, stratified, multistage, clustered sampling method in-cluded 15,421 subjects aged ≥20 years with no history of ocular surgery or glaucoma who participated in the Korean National Health and Nutritional Examination Survey 2008-2011.
Univariate regression analyses showed statistically significant linear relationships between IOP and body mass index (BMI), smoking status, heavy drinking, systolic blood pressure, fasting blood glucose, total cholesterol, triglycerides, insulin, ho-meostasis model assessment of insulin resistance (HOMA-IR), metabolic syndrome (
We concluded that increased IOP was associated with age, BMI, heavy drinking, systolic blood pressure, total cho-lesterol, and refraction. There were statistically significant differences in IOP and refraction according to occupation.
Flow chart of the study population. Subjects with glaucoma or ocular surgery history were excluded. IOP = in-traocular pressure.
Boxplots of intraocular pressure (mmHg, mean ± SD) according to occupations. Analysis of variance (ANOVA) showed statistically significant difference in intraocular pressure according to occupations. * ANOVA,
Boxplots of refraction (diopters, mean ± SD) according to occupations. Analysis of variance (ANOVA) showed statistically significant difference in refraction according to occupations. * ANOVA,
Baseline characteristics of the study subjects
Total (N = 15,421) | |
---|---|
Age (years) | 48.9 ± 16.1 |
Sex: Female (n, %) | 8,815 (57.16) |
Body weight (kg) | 62.26 ± 11.53 |
Height (cm) | 162.1 ± 9.27 |
BMI (kg/m2) | 23.61 ± 3.35 |
WC (cm) | 81.07 ± 9.96 |
IOP (mmHg) | 13.9 ± 2.7 |
Total body fat mass (kg) | 9.1 ± 3.52 |
Total body fat percentage (%) | 29.3 ± 8.3 |
Current smokers (n, %) | 3,452 (22.56) |
Heavy drinkers (n, %) | 7,077 (46.13) |
Regular exercisers (n, %) | 1,822 (11.84) |
SBP (mmHg) | 119.1 ± 17.7 |
DBP (mmHg) | 76.7 ± 10.9 |
FBS (mg/dL) | 97.6 ± 23.2 |
TG (mg/dL) | 134.2 ± 111 |
TC (mg/dL) | 187.7 ± 35.9 |
Insulin (μ IU/mL) | 9.9 ± 5.6 |
HOMA-IR | 2.5 ± 2.1 |
HDL (mg/dL) | 48.1 ± 11.1 |
LDL (mg/dL) | 113.1 ± 32.7 |
Refraction (diopters) | -0.9 ± 2.3 |
Metabolic syndrome (n, %) | 3,267 (22.02) |
Education (n, %) | |
Elementary school | 4,062 (26.6) |
Middle school | 1,720 (11.3) |
High school | 5,258 (34.4) |
University or higher | 4,249 (27.8) |
Lowest income (n, %) | 3,767 (24.8) |
Occupation (n, %) | |
Office workers | 1,222 (8.0) |
Administrator, management, professional | 1,782 (11.7) |
Sales and related occupations | 1,958 (12.9) |
Farming, fishing, and foresty occupations | 1,425 (9.4) |
Installation, maintenance, and repair occupations, technicians | 1,458 (9.6) |
Laborer | 1,314 (8.6) |
Unemployed | 6,073 (39.9) |
Family history of glaucoma (n, %) | 274 (1.8) |
Values are presented as mean ± SD or n (%).
BMI = body mass index; WC = waist circumference; IOP = intra-ocular pressure; SBP = systolic blood pressure; DBP = diastolic blood pressure; FBS = fasting blood sugar; TG = triglycerides; TC = total cholesterol; HOMA-IR = homeostasis model assess-ment of insulin resistance; HDL = high density lipoprotein choles-terol; LDL = low density lipoprotein cholesterol.
Univariate and multivariate linear regression analyses of factors associated with intraocular pressure in all study subjects
Univariate Model | Multivariate Model 1 | Multivariate Model 2 | |||||||
---|---|---|---|---|---|---|---|---|---|
Coef | SE | Coef | SE | Coef | SE | ||||
Age | -0.004 | 0.001 | 0.001 | -0.008 | 0.002 | <0.001 | -0.008 | 0.002 | <0.001 |
BMI | 0.066 | 0.006 | <0.001 | 0.028 | 0.008 | <0.001 | 0.036 | 0.007 | <0.001 |
Current smoking | <0.001 | 0.299 | |||||||
Past vs. Never | 0.195 | 0.058 | 0.001 | 0.083 | 0.062 | 0.181 | |||
Current vs. Never | 0.202 | 0.054 | <0.001 | 0.073 | 0.061 | 0.230 | |||
Heavy drinkers | 0.275 | 0.044 | <0.001 | 0.129 | 0.052 | 0.013 | 0.170 | 0.047 | <0.001 |
Regular exercisers | 0.058 | 0.068 | 0.391 | ||||||
SBP | 0.013 | 0.001 | <0.001 | 0.015 | 0.002 | <0.001 | 0.016 | 0.002 | <0.001 |
FBS | 0.007 | 0.001 | <0.001 | 0.006 | 0.001 | <0.001 | 0.006 | 0.001 | <0.001 |
TG | 0.001 | 0.000 | <0.001 | 0.000 | 0.000 | 0.784 | 0.003 | 0.001 | <0.001 |
TC | 0.004 | 0.001 | <0.001 | 0.003 | 0.001 | <0.001 | |||
Insulin | 0.025 | 0.004 | <0.001 | 0.009 | 0.011 | 0.411 | |||
HOMA-IR | 0.070 | 0.010 | <0.001 | -0.013 | 0.033 | 0.685 | |||
HDL | -0.003 | 0.002 | 0.124 | ||||||
LDL | 0.002 | 0.001 | 0.003 | ||||||
Refraction | -0.094 | 0.010 | <0.001 | -0.102 | 0.011 | <0.001 | -0.103 | 0.011 | <0.001 |
Metabolic syndrome | 0.466 | 0.053 | <0.001 | 0.132 | 0.070 | 0.060 | |||
Family history of glaucoma | 0.171 | 0.165 | 0.302 | ||||||
Office workers | 0.176 | 0.081 | 0.029 | 0.069 | 0.083 | 0.405 |
Multivariate Model 1: included all significant factors in Univariate Model, but excluded LDL due to multicollinearity.
Multivariate Model 2: applied selected stepwise selection method on Multivariate Model 1.*
Coef = coefficient; SE = standard error; BMI = body mass index; SBP = systolic blood pressure; FBS = fasting blood sugar; TG = trigly-cerides; TC = total cholesterol; HOMA-IR = homeostasis model assessment of insulin resistance; HDL = high density lipoprotein cholesterol; LDL = low density lipoprotein cholesterol.