Metabolic syndrome increases risk for high-ocular tension

19 February 2010

MedWire News: Presence of the metabolic syndrome increases the risk for high-ocular tension (HOT), a major cause of primary open angle glaucoma, report researchers.

Previous research has shown that mean intra-ocular pressure (IOP) has a tendency to increase in a linear fashion in the presence of increasing numbers of metabolic syndrome components.

In this study, Masahide Hamaguchi (Kyoto Prefectural University of Medicine, Japan) and colleagues assessed links between HOT – defined as a right eye IOP of more than 21 mmHg with no history of optic-disc abnormalities or receiving anti-glaucoma therapy – and presence of the metabolic syndrome as defined by the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria.

The team recruited 8031 Japanese men and 5972 Japanese women to take part in the study. The participants were aged 46 years on average and had a mean IOP of 14.8 mmHg.

Overall, 2.4% of men and 1.1% of women in the study had HOT, and 15.3% and 5.1%, respectively, had the metabolic syndrome.

Of those with the metabolic syndrome, 4.1% of men and 4.6% of women had HOT compared with 2.1% and 0.9% of men and women without it.

The researchers found that presence of the metabolic syndrome significantly increased the risk for HOT 2.02-fold in men and 5.28-fold in women. Increasing numbers of metabolic syndrome components were associated with increasing IOP and subsequent HOT.

When the researchers evaluated each metabolic syndrome component separately, they found that elevated fasting glucose, high blood pressure, and high triglycerides were most commonly associated with HOT in both men and women.

“The prevalence of the metabolic syndrome was associated with high-ocular tension, which represents ocular hypertension (OH) in this study,” write the authors in the International Journal of Obesity.

“It has been reported that primary open angle glaucoma develops from 1% to 2% of OH cases every year and that the higher IOP the patients have, the greater possibility they have of developing primary open angle glaucoma.”

Hamaguchi et al suggest: “To improve glaucoma treatment in patients with the metabolic syndrome, those patients should be provided with instruction on how to lessen their metabolic syndrome component levels.

“The medication for blood pressure or triglycerides could decrease high IOP, which often accompanies the metabolic syndrome. However, this possibility requires validation by a future longitudinal study.”

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Int J Obes 2010; Advance online publication